吸入麻醉藥與腦保護的研究進展_West China Medical Journal

Authors：

 李鈺 , 陳烽烽 ,  陳向東

四川大學華西醫院麻醉科（成都，610041）;

Corresponding?author：

陳向東, Email: xiangdong_chen@yahoo.com

Keywords：

吸入麻醉藥; 腦保護

DOI：

10.7507/1002-0179.20140172

Video：

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Abstract Full text Figures/Tables Video References Cited by

圍手術期間由于手術本身的影響以及血流動力學變化可以導致全身各個系統、器官特別是腦缺血等損傷，因此對大腦等重要器官的保護是臨床重要課題。圍麻醉期間所使用的吸入麻醉劑很早就被報道有器官保護作用，大量動物實驗已經證實吸入麻醉藥的預處理和后處理有腦保護作用。其腦保護作用機制主要涉及調節鈣離子濃度，降低谷氨酸鹽的神經毒性，抑制N-甲基-D-天冬氨酸受體活性等。現對吸入麻醉藥腦保護作用的不同影響因素及可能的作用機制進行綜述。

Citation： 李鈺, 陳烽烽, 陳向東. 吸入麻醉藥與腦保護的研究進展. West China Medical Journal, 2014, 29(3): 568-571. doi: 10.7507/1002-0179.20140172 Copy

1.	Nasu I, Yokoo N, Takaoka S, et al. The dose-dependent effects of isoflurane on outcome from severe forebrain ischemia in the rat[J]. Anesth Analg, 2006, 103(2):413-418.
2.	Popovic R, Liniger R, Bickler PE. Anesthetics and mild hypothermia similarly prevent hippocampal neuron death in an in vitro model of cerebral ischemia[J]. Anesthesiology, 2000, 92(5):1343-1349.
3.	Lasarzik I, Noppens RR, Wolf T, et al. Dose-dependent influence of sevoflurane anesthesia on neuronal survival and cognitive outcome after transient forebrain ischemia in Sprague-Dawley rats[J]. Neurocrit Care, 2011, 15(3):577-584.
4.	Lee HM, Lee DH, Choi JH, et al. Sevoflurane-induced post-conditioning has no beneficial effects on neuroprotection after incomplete cerebral ischemia in rats[J]. Acta Anaesthesiol Scand, 2010, 54(3):328-336.
5.	Zhu W, Wang L, Zhang L, et al. Isoflurane preconditioning neuroprotection in experimental focal stroke is androgen-dependent in male mice[J]. Neuroscience, 2010, 169(2):758-769.
6.	Kitano H, Young JM, Cheng J, et al. Gender-specific response to isoflurane preconditioning in focal cerebral ischemia[J]. J Cereb Blood Flow Metab, 2007, 27(7):1377-1386.
7.	Zhan X, Fahlman CS, Bickler PE. Isoflurane neuroprotection in rat hippocampal slices decreases with aging:changes in intracellular Ca2+ regulation and N-methyl-D-aspartate receptor-mediated Ca2+ influx[J]. Anesthesiology, 2006, 104(5):995-1003.
8.	Kawaguchi M, Kimbro JR, Drummond JC, et al. Isoflurane delays but does not prevent cerebral infarction in rats subjected to focal ischemia[J]. Anesthesiology, 2000, 92(5):1335-1342.
9.	Li L, Zuo Z. Isoflurane preconditioning improves short-term and long-term neurological outcome after focal brain ischemia in adult rats[J]. Neuroscience, 2009, 164(2):497-506.
10.	Blanck TJ, Haile M, Xu F, et al. Isoflurane pretreatment ameliorates postischemic neurologic dysfunction and preserves hippocampal Ca2+/calmodulin-dependent protein kinase in a canine cardiac arrest model[J]. Anesthesiology, 2000, 93(5):1285-1293.
11.	McMurtrey RJ, Zuo Z. Isoflurane preconditioning and postconditioning in rat hippocampal neurons[J]. Brain Res, 2010, 1358(13):184-190.
12.	Patel PM, Drummond JC, Cole DJ, et al. Isoflurane reduces ischemia-induced glutamate release in rats subjected to forebrain ischemia[J]. Anesthesiology, 1995, 82(4):996-1003.
13.	Engelhard K, Werner C, Hoffman WE, et al. The effect of sevoflurane and propofol on cerebral neurotransmitter concentrations during cerebral ischemia in rats[J]. Anesth Analg, 2003, 97(4):1155-1161.
14.	Nishizawa Y. Glutamate release and neuronal damage in ischemia[J]. Life Sci, 2001, 69(4):369-381.
15.	Warner DS, Zhou JG, Ramani R, et al. Reversible focal ischemia in the rat:effects of halothane, isoflurane, and methohexital anesthesia[J]. J Cereb Blood Flow Metab, 1991, 11(5):794-802.
16.	Tobin JR, Martin LD, Breslow MJ, et al. Selective anesthetic inhibition of brain nitric oxide synthase[J]. Anesthesiology, 1994, 81(5):1264-1269.
17.	Galley HF, Nelson LR, Webster NR. Anaesthetic agents decrease the activity of nitric oxide synthase from human polymorphonuclear leucocytes[J]. Br J Anaesth, 1995, 75(3):326-329.
18.	Hoetzel A, Geiger S, Loop T, et al. Differential effects of volatile anesthetics on hepatic heme oxygenase-1 expression in the rat[J]. Anesthesiology, 2002, 97(5):1318-1321.
19.	Hall AC, Lieb WR, Franks NP. Stereoselective and non-stereoselective actions of isoflurane on the GABAA receptor[J]. Br J Pharmacol, 1994, 112(3):906-910.
20.	Sun XD, Xu LX, Zhang H, et al. Effects of enflurane anesthesia on the neurotransmitters in different areas of the canine cerebrum[J]. J Pract Med, 2006, 22(13):1488-1490.
21.	Philip E. Bickler, MD David S. γ-Aminobutyric Acid-A receptors contribute to isoflurane neuroprotection in organotypic hippocampal cultures[J]. Anesth Analg, 2003, 97(2):564-571.
22.	Ye Z, Guo Q, Xia P, et al. Sevoflurane postconditioning involves an up-regulation of HIF-1α and HO-1 expression via PI3K/Akt pathway in a rat model of focal cerebral ischemia[J]. Brain Res, 2012, 1463:63-74.
23.	Lin HY, Yeh WL, Huang BR, et al. Desipramine protects neuronal cell death and induces heme oxygenase-1 expression in Mes23.5 dopaminergic neurons[J]. PLoS One, 2012, 7(11):e50138.
24.	Ballanyi K. Protective role of neuronal KATP channels in brain hypoxia[J]. J Exp Biol, 2004, 207(Pt 18):3201-3212.
25.	Kehl F, Payne RS, Roewer N, et al. Sevoflurane-induced preconditioning of rat brain in vitro and the role of KATP channels[J]. Brain Res, 2004, 1021(1):76-81.

1. Nasu I, Yokoo N, Takaoka S, et al. The dose-dependent effects of isoflurane on outcome from severe forebrain ischemia in the rat[J]. Anesth Analg, 2006, 103(2):413-418.
2. Popovic R, Liniger R, Bickler PE. Anesthetics and mild hypothermia similarly prevent hippocampal neuron death in an in vitro model of cerebral ischemia[J]. Anesthesiology, 2000, 92(5):1343-1349.
3. Lasarzik I, Noppens RR, Wolf T, et al. Dose-dependent influence of sevoflurane anesthesia on neuronal survival and cognitive outcome after transient forebrain ischemia in Sprague-Dawley rats[J]. Neurocrit Care, 2011, 15(3):577-584.
4. Lee HM, Lee DH, Choi JH, et al. Sevoflurane-induced post-conditioning has no beneficial effects on neuroprotection after incomplete cerebral ischemia in rats[J]. Acta Anaesthesiol Scand, 2010, 54(3):328-336.
5. Zhu W, Wang L, Zhang L, et al. Isoflurane preconditioning neuroprotection in experimental focal stroke is androgen-dependent in male mice[J]. Neuroscience, 2010, 169(2):758-769.
6. Kitano H, Young JM, Cheng J, et al. Gender-specific response to isoflurane preconditioning in focal cerebral ischemia[J]. J Cereb Blood Flow Metab, 2007, 27(7):1377-1386.
7. Zhan X, Fahlman CS, Bickler PE. Isoflurane neuroprotection in rat hippocampal slices decreases with aging:changes in intracellular Ca2+ regulation and N-methyl-D-aspartate receptor-mediated Ca2+ influx[J]. Anesthesiology, 2006, 104(5):995-1003.
8. Kawaguchi M, Kimbro JR, Drummond JC, et al. Isoflurane delays but does not prevent cerebral infarction in rats subjected to focal ischemia[J]. Anesthesiology, 2000, 92(5):1335-1342.
9. Li L, Zuo Z. Isoflurane preconditioning improves short-term and long-term neurological outcome after focal brain ischemia in adult rats[J]. Neuroscience, 2009, 164(2):497-506.
10. Blanck TJ, Haile M, Xu F, et al. Isoflurane pretreatment ameliorates postischemic neurologic dysfunction and preserves hippocampal Ca2+/calmodulin-dependent protein kinase in a canine cardiac arrest model[J]. Anesthesiology, 2000, 93(5):1285-1293.
11. McMurtrey RJ, Zuo Z. Isoflurane preconditioning and postconditioning in rat hippocampal neurons[J]. Brain Res, 2010, 1358(13):184-190.
12. Patel PM, Drummond JC, Cole DJ, et al. Isoflurane reduces ischemia-induced glutamate release in rats subjected to forebrain ischemia[J]. Anesthesiology, 1995, 82(4):996-1003.
13. Engelhard K, Werner C, Hoffman WE, et al. The effect of sevoflurane and propofol on cerebral neurotransmitter concentrations during cerebral ischemia in rats[J]. Anesth Analg, 2003, 97(4):1155-1161.
14. Nishizawa Y. Glutamate release and neuronal damage in ischemia[J]. Life Sci, 2001, 69(4):369-381.
15. Warner DS, Zhou JG, Ramani R, et al. Reversible focal ischemia in the rat:effects of halothane, isoflurane, and methohexital anesthesia[J]. J Cereb Blood Flow Metab, 1991, 11(5):794-802.
16. Tobin JR, Martin LD, Breslow MJ, et al. Selective anesthetic inhibition of brain nitric oxide synthase[J]. Anesthesiology, 1994, 81(5):1264-1269.
17. Galley HF, Nelson LR, Webster NR. Anaesthetic agents decrease the activity of nitric oxide synthase from human polymorphonuclear leucocytes[J]. Br J Anaesth, 1995, 75(3):326-329.
18. Hoetzel A, Geiger S, Loop T, et al. Differential effects of volatile anesthetics on hepatic heme oxygenase-1 expression in the rat[J]. Anesthesiology, 2002, 97(5):1318-1321.
19. Hall AC, Lieb WR, Franks NP. Stereoselective and non-stereoselective actions of isoflurane on the GABAA receptor[J]. Br J Pharmacol, 1994, 112(3):906-910.
20. Sun XD, Xu LX, Zhang H, et al. Effects of enflurane anesthesia on the neurotransmitters in different areas of the canine cerebrum[J]. J Pract Med, 2006, 22(13):1488-1490.
21. Philip E. Bickler, MD David S. γ-Aminobutyric Acid-A receptors contribute to isoflurane neuroprotection in organotypic hippocampal cultures[J]. Anesth Analg, 2003, 97(2):564-571.
22. Ye Z, Guo Q, Xia P, et al. Sevoflurane postconditioning involves an up-regulation of HIF-1α and HO-1 expression via PI3K/Akt pathway in a rat model of focal cerebral ischemia[J]. Brain Res, 2012, 1463:63-74.
23. Lin HY, Yeh WL, Huang BR, et al. Desipramine protects neuronal cell death and induces heme oxygenase-1 expression in Mes23.5 dopaminergic neurons[J]. PLoS One, 2012, 7(11):e50138.
24. Ballanyi K. Protective role of neuronal KATP channels in brain hypoxia[J]. J Exp Biol, 2004, 207(Pt 18):3201-3212.
25. Kehl F, Payne RS, Roewer N, et al. Sevoflurane-induced preconditioning of rat brain in vitro and the role of KATP channels[J]. Brain Res, 2004, 1021(1):76-81.

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吸入麻醉藥與腦保護的研究進展

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