Chi O Z, Wei H M, O'Hara D A, Sinha A K, Weiss H R
Department of Anesthesia, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick 08903-0019.
Anesthesiology. 1993 Aug;79(2):299-305. doi: 10.1097/00000542-199308000-00015.
When compared with barbiturates, isoflurane may lack protective effects during focal cerebral ischemia. The reason for this difference is not clear. In this study, regional cerebral blood flow (rCBF), arterial and venous O2 saturation, and O2 extraction were compared in the ischemic cortex and in the nonischemic brain regions of rats anesthetized with isoflurane or pentobarbital using a microspectrophotometric technique that directly measures the O2 saturation of blood in the small arteries and veins.
Twenty-eight rats were anesthetized with 1.4% isoflurane or 50 mg/kg pentobarbital. One hour after a middle cerebral artery (MCA) occlusion, rCBF was measured in the ischemic cortex and in the nonischemic brain regions using 14C-iodoantipyrine in one-half of each group of animals. Regional arterial and venous O2 saturation were determined using microspectrophotometry in the other one-half of each group.
The rCBF of the ischemic cortex (IC) and the non-ischemic contralateral cortex (CC) of the isoflurane group were significantly higher than those of the pentobarbital group. The venous O2 saturation was significantly less, and the O2 extraction was significantly higher, in the IC than in the nonischemic regions in both groups of animals (pentobarbital group, IC 10.5 +/- 1.1 ml O2.100 ml blood-1, CC 6.3 +/- 0.7; isoflurane group, IC 10.8 +/- 0.6, CC 5.9 +/- 0.2). There was no significant difference between the two groups.
Because the rCBF was less and the O2 extraction was similar, O2 consumption in the focal ischemic area of the brain during pentobarbital anesthesia must have been less than that during isoflurane anesthesia.
与巴比妥类药物相比,异氟烷在局灶性脑缺血期间可能缺乏保护作用。这种差异的原因尚不清楚。在本研究中,使用直接测量小动脉和静脉中血氧饱和度的显微分光光度技术,比较了用异氟烷或戊巴比妥麻醉的大鼠缺血皮质和非缺血脑区的局部脑血流量(rCBF)、动脉和静脉血氧饱和度以及氧摄取情况。
28只大鼠用1.4%异氟烷或50mg/kg戊巴比妥麻醉。大脑中动脉(MCA)闭塞1小时后,每组动物的一半用14C-碘安替比林测量缺血皮质和非缺血脑区的rCBF。每组另一半用显微分光光度法测定局部动脉和静脉血氧饱和度。
异氟烷组缺血皮质(IC)和对侧非缺血皮质(CC)的rCBF显著高于戊巴比妥组。两组动物的IC中静脉血氧饱和度显著低于非缺血区,氧摄取显著高于非缺血区(戊巴比妥组,IC为10.5±1.1ml O2·100ml血液-1,CC为6.3±0.7;异氟烷组,IC为10.8±0.6,CC为5.9±0.2)。两组之间无显著差异。
由于rCBF较低且氧摄取相似,戊巴比妥麻醉期间脑局灶缺血区的氧消耗必定低于异氟烷麻醉期间。