Zarchin N, Guggenheimer-Furman E, Meilin S, Ornstein E, Mayevsky A
Department of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.
Brain Res. 1998 Jan 12;780(2):230-6. doi: 10.1016/s0006-8993(97)01188-8.
Temporary interruption or reduction of cerebral blood flow during cerebrovascular surgery may rapidly result in ischemia or cerebral infarction. Thiopental has been shown to have cerebroprotective effects. However, the cerebroprotective dose of thiopental causes burst suppression of the EEG, thus this parameter cannot be used continuously for the detection of metabolic changes in the brain during thiopental anaesthesia. This study was performed in order to examine whether the multiparametric assembly (MPA), which measures energy metabolism CBF and mitochondrial (NADH) as well as extracellular ion concentrations (K+), can shed light on the mechanism of the cerebroprotective effects of thiopental. The MPA was placed on the brain of Mongolian gerbils and burst suppression of the ECoG was induced by thiopental. Cerebral ischemia was induced by occlusion of carotid arteries after burst suppression. Burst suppression of the ECoG was accompanied by a significant decrease in cerebral blood flow. In animals that received thiopental prior to ischemia, NADH increased to a lesser degree and extracellular potassium ion concentration increased to a lesser degree than in the control animals, indicating that thiopental affords protection of the brain under ischemic conditions due to improved energy metabolism. This study also demonstrates that the MPA can monitor changes occurring in the cerebral cortex even after the ECoG can no longer be used. Those findings have a significant value in the development of a new clinical monitoring device.
脑血管手术期间脑血流的暂时中断或减少可能会迅速导致缺血或脑梗死。已证明硫喷妥钠具有脑保护作用。然而,硫喷妥钠的脑保护剂量会导致脑电图出现爆发抑制,因此在硫喷妥钠麻醉期间,该参数不能持续用于检测大脑中的代谢变化。进行本研究是为了检验多参数组合(MPA),即测量能量代谢、脑血流量和线粒体(NADH)以及细胞外离子浓度(K+),是否能阐明硫喷妥钠脑保护作用的机制。将MPA置于蒙古沙鼠的大脑上,并用硫喷妥钠诱导脑电图的爆发抑制。在爆发抑制后通过阻断颈动脉诱导脑缺血。脑电图的爆发抑制伴随着脑血流量的显著下降。在缺血前接受硫喷妥钠的动物中,与对照动物相比,NADH升高程度较小,细胞外钾离子浓度升高程度较小,这表明硫喷妥钠由于改善了能量代谢,在缺血条件下为大脑提供了保护。本研究还表明,即使脑电图不再可用,MPA仍可监测大脑皮层中发生的变化。这些发现对开发一种新的临床监测设备具有重要价值。