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中度低温和鞘内注射丁卡因对兔短暂性脊髓缺血时鞘内透析液谷氨酸浓度以及神经和组织病理学结果的影响。

The effects of moderate hypothermia and intrathecal tetracaine on glutamate concentrations of intrathecal dialysate and neurologic and histopathologic outcome in transient spinal cord ischemia in rabbits.

作者信息

Wakamatsu H, Matsumoto M, Nakakimura K, Sakabe T

机构信息

Department of Anesthesiology-Resuscitology, Yamaguchi University School of Medicine, Japan.

出版信息

Anesth Analg. 1999 Jan;88(1):56-62. doi: 10.1097/00000539-199901000-00011.

Abstract

UNLABELLED

The aim of the present study was to compare the effects of intrathecal tetracaine (a sodium channel blocker) with those of moderate hypothermia on glutamate concentrations of intrathecal dialysate, hindlimb motor functions, and histopathology in spinal cord ischemia. New Zealand White rabbits implanted with an intrathecal dialysis probe were assigned to one of the three groups (seven in each): control (temperature 38 degrees C), tetracaine (tetracaine 0.5%, 0.6 mL, given intrathecally 30 min before ischemia, 38 degrees C), or moderate hypothermia (32 degrees C). Spinal cord ischemia (20 min) was produced by occlusion of the abdominal aorta during isoflurane (1%) anesthesia. Glutamate concentrations significantly increased during ischemia in all groups, but the levels in the moderate hypothermia group were significantly lower than those in the control and tetracaine groups. Neurologic status (24 and 48 h after reperfusion) and histopathology (48 h) in the moderate hypothermia group were significantly better than in the other two groups. There were no significant differences between the tetracaine and control groups in either glutamate concentrations, neurologic status, or histopathology. We conclude that intrathecal tetracaine does not provide any protection against ischemic spinal cord injury, whereas moderate hypothermia does.

IMPLICATIONS

Sodium channel blockers, including local anesthetics, have been shown to reduce glutamate release in brain ischemia and have a neuroprotective effect. However, in the present study, intrathecal tetracaine did not attenuate either glutamate release or the neurologic or histopathologic outcome in spinal cord ischemia, whereas moderate hypothermia did.

摘要

未标记

本研究的目的是比较鞘内注射丁卡因(一种钠通道阻滞剂)与中度低温对脊髓缺血时鞘内透析液谷氨酸浓度、后肢运动功能及组织病理学的影响。将植入鞘内透析探针的新西兰白兔分为三组(每组7只):对照组(体温38℃)、丁卡因组(丁卡因0.5%,0.6 mL,在缺血前30分钟鞘内注射,体温38℃)或中度低温组(32℃)。在异氟烷(1%)麻醉期间通过阻断腹主动脉造成脊髓缺血(20分钟)。所有组在缺血期间谷氨酸浓度均显著升高,但中度低温组的水平显著低于对照组和丁卡因组。中度低温组再灌注后24小时和48小时的神经状态以及48小时的组织病理学均显著优于其他两组。丁卡因组和对照组在谷氨酸浓度、神经状态或组织病理学方面均无显著差异。我们得出结论,鞘内注射丁卡因对缺血性脊髓损伤无任何保护作用,而中度低温则有保护作用。

启示

包括局部麻醉药在内的钠通道阻滞剂已被证明可减少脑缺血时谷氨酸的释放并具有神经保护作用。然而,在本研究中,鞘内注射丁卡因并未减轻脊髓缺血时的谷氨酸释放或神经及组织病理学结果,而中度低温则有此作用。

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