Effect of Type of Anesthesia and Lower-Abdominal Laparotomy in Mice on the Cytokine Response to Acute Stress
Effect of Type of Anesthesia and Lower-Abdominal Laparotomy in Mice on the Cytokine Response to Acute Stress
复制标题
小鼠麻醉类型和下腹部剖腹手术对细胞因子对急性应激反应的影响
DOI：
10.1136/rapm-00115550-199621050-00014
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发表时间：
1996
影响因子：
5.1
通讯作者：
N. M. Burdash
中科院分区：
文献类型：
--
作者：
E. Fu;J. Norman;J. Scharf;N. M. Burdash
背景和目的近年来，全身细胞因子水平作为急性手术应激严重程度的指标的准确性受到重视。在本研究中，开发了一种小鼠动物模型，以确定麻醉类型对细胞因子对标准手术应激反应的影响。方法30只Balb C小鼠在氟烷麻醉和剖腹探查后，通过测定促炎性细胞因子的释放来评估急性应激反应的严重程度。通过0、1、2、4和6小时的血清肾上腺素和C-反应蛋白水平评估手术应激的严重程度，并与全身白细胞介素-1、白细胞介素-6和肿瘤坏死因子-α水平进行比较。在下一阶段，为了评估与麻醉诱导相关的应激反应，在10只接受氟烷麻醉或氟烷-脊髓联合麻醉的小鼠中测量IL-6。在最后一系列实验中，设计用于评估麻醉剂类型对标准手术应激诱导的应激反应的影响，40只小鼠接受氟烷麻醉和剖腹手术或氟烷-脊髓联合麻醉和剖腹手术。结果剖腹探查术后2 h血清肾上腺素显著升高（P <0.05），而C反应蛋白在6 h升高（P <0.05）。血清白细胞介素-6迅速升高，在2小时达到峰值（P <0.001），然后下降到6小时，但白细胞介素-1和肿瘤坏死因子仅在少数接受剖腹手术的动物中升高。在没有手术应激的情况下，氟烷或氟烷/脊髓联合麻醉对白细胞介素-6应激反应均无任何影响。同样，剖腹探查术后的手术应激程度不受麻醉类型的影响。结论血清IL-6是反映急性手术应激的最佳指标，单纯的麻醉干预不能引起急性手术应激。在接受腹部手术的动物中，与单独氟烷麻醉相比，氟烷与脊髓麻醉的组合不能减轻应激程度。
Background and Objective Recent emphasis has been placed on the accuracy of systemic cytokine levels as an index to the severity of acute surgical stress. In this investigation, a murine animal model was developed to determine the effect of the type of anesthesia on the cytokine response to a standard surgical stress. Methods The initial phase was designed to assess the severity of the acute stress response to a standard surgical stimulus by measuring the release of proinflammtory cytokines in 30 Balb C mice subjected to halothane anesthesia and exploratory laparotomy. The severity of the operative stress was assessed by serum levels of epinephrine and C-reactive protein at 0, 1, 2, 4, and 6 hours and compared with systemic levels of interleukin-1, interleukin-6, and tumor necrosis factor-alpha. In the next phase, in order to assess the stress response associated with the induction of anesthesia without surgery, IL-6 was measured in 10 mice undergoing halothane anesthesia or combined halothane-spinal anesthesia. In the final series of experiments, designed to assess the effect of anesthetic type on the stress response induced by the standard surgical stress, 40 mice underwent halothane anesthesia with laparotomy or combined halothane-spinal anesthesia with laparotomy. Results Following exploratory laparotomy, serum epinephrine was significantly elevated at 2 hours (P < .05 vs time 0), while C-reactive protein became elevated at 6 hours (P < .05). Serum inter-leukin-6 rose rapidly, reaching a peak at hour 2 (P < .001) and then declining through hour 6, but interleukin-1 and tumor necrosis factor, were elevated in only a few animals undergoing laparotomy. Neither halothane nor combined halothane/spinal anesthesia had any effect on the interleukin-6 stress response in the absence of surgical stress. Similarly, the degree of operative stress after exploratory laparotomy was not affected by the type of anesthesia. Conclusions Serum interleukin-6 was the best marker for acute surgical stress, which could not be induced by anesthetic interventions alone. The combination of halothane with spinal anesthesia was not able to attenuate the degree of stress as compared with halothane anesthesia alone in animals undergoing abdominal surgery.