【摘要】 目的探讨20%长链脂肪乳剂对脑室注射局麻药引起的氨基酸神经递质失衡的影响。方法选择30只健康成年雄性SD大鼠,随机分为两组:正常组(C组,n=10)和局麻药中毒组(L组,n=20)。L组按处理不同分为对照组(S组,n=10)和脂肪乳治疗组(I组,n=10)。L组大鼠经右侧侧脑室以50μl/min速度注入0.75%左旋布比卡因,脑电出现惊厥波时持续输注20%长链脂肪乳剂0.25ml·kg-1·min-1(I组)或生理盐水(S组),C组大鼠不予任何处理,持续监测三组大鼠EEG、ECG和SpO2。观察三组大鼠惊厥持续时间、左旋布比卡因惊厥阈值及建模后24h死亡率,同时检测脑脊液中神经递质谷氨酸(Glu)和γ-氨基丁酸(GABA)浓度以及海马区N-甲基-D-天冬氨酸受体1(NMDAR1)的表达,计算Glu和GABA浓度比值,并分析Glu与NMDAR1表达的相关性。结果 S组大鼠惊厥持续时间明显长于,建模后24h死亡率明显高于,惊厥阈值明显低于I组(P<0.05)。S组和I组大鼠脑脊液Glu与GABA浓度、Glu/GABA及海马区NMDAR1的表达均明显高于C组(P<0.05),S组大鼠脑脊液Glu浓度、Glu/GABA及海马区NMDAR1的表达均明显高于I组(P<0.05),脑脊液中Glu含量与NMDAR1呈正相关(r=0.884,P<0.01)。结论静脉输注20%长链脂肪乳剂可通过有效改善局麻药引起的脑内Glu和GABA失衡而发挥抗中枢神经毒性作用。更多还原

【Abstract】 Objective To investigate the effect of intravenous injection of 20%lipid emulsion on neurotransmitters imbalance in central nerve system induced by local anesthetics.Methods Thirty adult Sprague-Dawley rats were randomly divided into two groups:normal group(group C,n=10)and local anesthetics group(group L,n=20).Based on different treatment,the rats in group L were assigned into two subgroup:control group(group S,n=10)and 20%long-chain lipid emulsion injection group(group I,n=10).The rats of group L were injected with 0.75%levobupivacaine at 50μl/min from the right ventricle of brain.When convulsions wave of electroencephalogram EEG appeared,20%long-chain lipid emulsion was administrated continuously 0.25ml·kg-1·min-1(group I)or normal saline(group S).The rats in group C were without any treatment.All the rats were continously monitored by EEG,ECG and SpO2.The primary outcome included seizure duration and threshold and rats’ mortality of postoperative 24 h.Secondary outcome included the concentrations of neurotransmitters GABA and Glu in cerebrospinal fluid,expression of NMDAR1 in cortex,Glu/GABA concentration ratio(Glu/GABA),and analysis the correlation between expression of Glu and NMDAR1.Results The convulsion time and mortality of rats in group S were significantly increased compared with those in group I(P<0.05).The seizure threshold of levobupivacaine was much lower in group S than group I(P<0.05).Compared with group C,the concentrations of Glu and GABA in cerebrospinal fluid,expression of NMDAR1 in hippocampus and Glu/GABA significantly increased in groups S and I(P <0.05),and at same time these data in group S were significantly higher than group I(P <0.05).There is a positive correlation between concentration of Glu in CSF and expression of NMDAR1 in hippocampus(r=0.884,P<0.01).Conclusion Intravenous infusion of20%long-chain lipid emulsion can effectively improve neurotransmitters imbalance in central nerve system induced by intraventricular injection of local anesthetics.更多还原