Antognini J F, Carstens E
Department of Anesthesiology, University of California, Davis 95616, USA.
Anesthesiology. 1999 Jan;90(1):208-14. doi: 10.1097/00000542-199901000-00027.
The spinal cord appears to be the site at which isoflurane suppresses movement that occurs in response to a noxious stimulus. In an attempt to localize its site of suppressant action, the authors determined the effect of isoflurane on dorsal horn neuronal responses to supramaximal noxious stimulation at end-tidal concentrations that just permitted and just prevented movement.
Rats (n = 14) were anesthetized with isoflurane, and after lumbar laminectomy, the minimum alveolar concentration (MAC) for each rat was determined using a supramaximal mechanical stimulus. In these same rats, after extracellular microelectrode placement in the lumbar spinal cord, dorsal horn neuronal responses to the supramaximal stimulus were determined at the concentrations of isoflurane that bracketed each rat's MAC (0.1% higher and lower than MAC). The MAC of isoflurane was then re-determined.
Dorsal horn neuronal response was 1,757+/-892 impulses/min at 0.9 MAC and 1,508+/-988 impulses/min at 1.1 MAC, a 14% decrease (P < 0.05). Cell responses varied, with some cells increasing their response at the higher concentration of isoflurane. The MAC of isoflurane was 1.38+/-0.2% before and 1.34+/-0.2% after determination of dorsal horn neuronal responses.
Isoflurane, at concentrations that bracket MAC, has a variable and minimal depressant effect on dorsal horn cell responses to noxious mechanical stimulation. These data suggest that the major action of isoflurane to suppress movement evoked by a noxious stimulus might occur primarily at a site other than the dorsal horn.
脊髓似乎是异氟烷抑制对有害刺激产生的运动的部位。为了确定其抑制作用位点,作者测定了异氟烷在刚好允许和刚好阻止运动的呼气末浓度下对背角神经元对超强有害刺激的反应的影响。
用异氟烷麻醉大鼠(n = 14),在腰椎椎板切除术后,使用超强机械刺激确定每只大鼠的最低肺泡浓度(MAC)。在这些相同的大鼠中,将细胞外微电极置于腰脊髓后,在高于和低于每只大鼠MAC 0.1%的异氟烷浓度下,测定背角神经元对超强刺激的反应。然后重新测定异氟烷的MAC。
在0.9 MAC时,背角神经元反应为1757±892次冲动/分钟,在1.1 MAC时为1508±988次冲动/分钟,减少了14%(P < 0.05)。细胞反应各不相同,一些细胞在较高异氟烷浓度下反应增加。测定背角神经元反应前异氟烷的MAC为1.38±0.2%,测定后为1.34±0.2%。
在MAC上下的浓度范围内,异氟烷对背角细胞对有害机械刺激的反应具有可变且最小的抑制作用。这些数据表明,异氟烷抑制有害刺激诱发运动的主要作用可能主要发生在背角以外的部位。