氯胺酮联合应用咪唑安定麻醉对大鼠局灶性脑缺血损伤的影响

Effects of Ketamine and Midazolam Combination Anesthesia on Focal Cerebral Ischemia Injury in Rats

目的 研究氯胺酮联合应用咪唑安定麻醉对大鼠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-咪唑安定麻醉下制备永久性大脑中动脉阻塞模型。术后4 h行神经病学评分、2 4 h测量梗塞体积、3d进行TU NEL染色检测半暗带内的细胞凋亡。结果 在氯胺酮-咪唑安定组和氯胺酮组间,神经病学评分(1.74±0 .5 2 vs 1.5 7±0 .6 5 )无显著性差异(P>0 .0 5 ) ,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〔梗塞体积:(2 4 .1±4 .6 3) % vs (38.4 8±4 .18) % ;凋亡细胞密度:(178±2 3) / mm2 vs(2 5 8±15 ) / mm2 ,P<0 .0 5〕。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 We investigated the effects of anesthesia with ketamine and midazolam on focal cerebral ischemia injury, and evaluated the neuroprotective properties of this combination during surgical procedures. Methods Thirty male Sprague-Dawley rats were subjected to permanent middle cerebral artery occlusion (MCAO) under ketamine or ketamine-midazolam intraperitoneal anesthesia (n=15 each). The neurological scoring was performed to determine functional impairment of the brain at 4 h after MCAO. TTC staining of brain slices was used to measure infarct size of the brain at 24 h after MCAO. At day 3 after MCAO, TUNEL staining was employed to detect apoptotic cells in the penumbra. Results Although neurological scoring (1.57±0.65 vs 1.74±0.52) was not significantly different between ketamine and ketamine-midazolam groups(P>0.05), infarct size and apoptotic cell density in the penumbra were significantly lower in the ketamine-midazolaml group than those in the ketaminel group 〔infarct size: (24.1±4.63)% vs (38.48±4.18)%; apoptotic cells density: (178±23) cells/mm2 vs (258±15) cells/mm2, P<0.05〕, respectively. Conclusion The above findings suggested that ketamine and midazolam combination might provide neuroprotection during surgical procedures that pose risk for ischemic cerebral injury.