Objective Sevoflurane preconditioning has been demonstrated to reduce cerebral ischemia–reperfusion（IR） injury,but the underlying mechanisms have not been fully elucidated.Besides,different protocols would usually lead to different results.The objective of this study was to determine whether dual exposure to sevoflurane improves the effect of anesthetic preconditioning against oxygen and glucose deprivation（OGD）injury in vitro.Methods Rat hippocampal slices under normoxic conditions（95%O2/5%CO2）were pre-exposed to sevoflurane 1,2 and 3 minimum alveolar concentration （MAC）for 30 min,once or twice,with 15-min washout after each exposure.The slices were then subjected to 13-min OGD treatment（95%N2/5%CO2,glucose-free）,followed by 30-min reoxygenation.The population spikes（PSs）were recorded in the CA1 region of rat hippocampus.The percentage of PS amplitude at the end of 30-min reoxygenation to that before OGD treatment was calculated,since it could indicate the recovery degree of neuronal function.In addition,to assess the role of mitogen-activated protein kinases（MAPKs）in preconditioning,U0126,an inhibitor of extracellular signal–regulated protein kinase（MEK-ERK1/2,ERK1/2 MAPK）,and SB203580,an inhibitor of p38 MAPK,were separately added 10 min before sevoflurane exposure.Results Preconditioning once with sevoflurane 1,2,and 3 MAC increased the percentage of PS amplitude at the end of 30-min reoxygenation to that before OGD treatment,from（15.13±3.79）%（control）to（31.88±5.36）%, （44.00±5.01）%,and（49.50±6.25）%,respectively,and twice preconditioning with sevoflurane 1,2,and 3 MAC increased the percentage to（38.53±4.36）%,（50.74±7.05）%and（55.86±6.23）%,respectively.The effect of duplicate preconditioning with sevoflurane 3 MAC was blocked by U0126[（16.23±4.62）%].Conclusion Sevoflurane preconditioning can induce neuroprotection against OGD injury in vitro,and preconditioning twice enhances this effect.Besides,the activation of extracellular signal
目的:探讨椎管内麻醉与全凭静脉麻醉对中年患者术后认知功能的影响。方法:择期行非心脏外科手术的中年患者100例随机分为2组各50例,A组采用全凭静脉麻醉,B组采用椎管内麻醉。同期中年健康志愿者50名为对照组。分别于术前1 d(T1),术后3 d(T2)和术后1个月(T3)对患者进行认知功能测定,并采用Z计分法评定术后认知功能受损及术后认知功能障碍发生情况。结果:术后3 d A组发生认知功能障碍5例(10%),认知受损17例(34%);B组发生认知功能障碍2例(4%),认知受损13例(26%),2组比较差异无统计学意义(P>0.05)。术后1个月A组发生认知功能障碍4例(8%),认知受损15例(30%);B组发生认知功能障碍1例(2%),认知受损6例(12%),2组认知功能障碍发生率比较差异无统计学意义(P>0.05),认知功能受损发生率比较差异有统计学意义(P<0.05)。结论:中年患者应用椎管内麻醉,可减少认知功能受损的发生率。
