氯胺酮咪唑安定麻醉对大鼠局灶性脑缺血损伤的影响

摘要

目的比较氯胺酮联合咪唑安定麻醉与单纯氯胺酮麻醉对局灶性脑缺血损伤的影响.方法30只SD大鼠在氯胺酮或氯胺酮-咪唑安定麻醉下制作永久性大脑中动脉阻塞模型.术后4 h行神经病学评分、24 h测量梗塞体积、72 h进行TUNEL染色检测半暗带内的细胞凋亡.结果术后4 h神经病学评分在氯胺酮-咪唑安定组和氯胺酮组间无显著性差异(1.74±0.52vs 1.57±0.65,P＞0.05),但氯胺酮-咪唑安定组大鼠的脑梗塞体积和半暗带内凋亡细胞密度明显低于氯胺酮组大鼠的相应参数(梗塞体积:24.1%±4.63%vs 38.48%±4.18%;凋亡细胞密度:178±23个/mm2vs 258±15个/mm2, P＞0.05).结论氯胺酮麻醉中联合应用咪唑安定对大鼠局灶性脑缺血损伤具有保护作用.%Objective To compare the effects of anesthesia with ketamine and ketamine-midazolam on focal cerebral ischemic injury in rats and evaluate the neuroprotective effect of ketamine-midazolam anesthesia during surgical procedures. Methods Thirty male Sprague-Dawley rats were subjected to permanent middle cerebral artery occlusion (MCAO) under anesthesia with intraperitoneal administration of ketamine alone or in combination with midazolam (n=15). Neurological scoring was conducted the infarct size measured at 4 h and 24 h after the surgery. Histological examination was performed using TUNEL staining 72 h after MCAO. Results After MCAO, the neurological scores showed no significant difference between ketamine and ketamine-midazolam groups (1.57±0.65 vs 1.74±0.52, P＞0.05), but the rats in the latter group had significantly smaller infarct size (38.48%±4.18% vs 24.1%±4.63%, P＜0.05) and lower apoptotic cell density (258±15 cells/mm2 vs 178±23 cells/mm2, P＜0.05) in the penumbra. Conclusion Compared with ketamine used alone, anesthesia with the combination of ketamine and midazolam may provide neuroprotection from ischemic cerebral injury by reducing the infarct size and lowering the cell apoptosis rate following MCAO in rats.