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The influence of spine distraction with hypotensive condition on spinal cord. An experimental study

低血压状态下脊柱牵引对脊髓的影响。

基本信息

批准号：
01480373
负责人：
ONOMURA Toshinobu
金额：
$ 3.26万
依托单位：
Osaka Medical College
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1991
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-01480373/
关键词：
Spine distraction Hypotension Spinal cord blood flow Spinal evoked potentials Spinal cord injuries レ-ザ-ドップラ-血流計

项目摘要

We evaluated the effects of hypotension maintained with hypotensive drugs, generally used for clinical hypotensive anesthesia, on the spinal cord in terms of spinal cord blood flow and spinal evoked potentials, paying attention to spinal autoregulation. (Methods)The arterial pressure was monitoured in adult rabbits under GOE anesthesia. Hypotension was induced with PGE_1 and nitroglycerin. After the systoric blood pressure was maintained at 30% of the normal pressure, drug administration was discontinued. After recovery of blood pressure, the blood pressure was reduced again by 50% and 70%, and spinal cord blood flow and spi-nal evoked potentials were serialluy measured. On the other hand, spine distraction was performed with 30% and 50% reductions of blood pressure with PGE_1.Serial changes in the spinal cord blood flow and spinal evoked potentials after release of traction were evaluated. Spinal cord blood flow was measured by the laser Doppler method. As spinal evoked potentials, as … More cending ans descending potentials were recorded using extrdural electorodes inserted via the L4/5and Th9/10 interlaminar spaces. The intensities of stimulation were three times the threshold(3T) and supra-maximum stimulation(SUPRA).(Results)1.In the hypotensive state maintained with each of the 2 drugs (nitroglycerin, prostaglandin) with different action mechanisms, the spinal blood flow was decreased, but the decrease was not correlated with the reduction rate in blood pressure. The recovery of spial cord blood flow after discontinuation of each drug was better at a lower reduction rate in blood pressure.2. As changes in the spinal evoked potentials with changes in blood pressure, chabges in the amplitude of the second potential after weak stimulation(3T) best reflected those in spial cord blood flow.3. After spine traction with a 30% or 50% reduction in blood pressure, spanal cord blood flow further decreased, but the decrease did not significantly differ between the two reduction rates. After release of spinal traction, spinal cord blood flowrecoverd at the 30% reduction state but further decreased at the 50% reduction state.4. Changes in the amplitude of the first potential after descending weak stimulation were similar to those of the second potential after weak stimulation. The effects of spinal distraction on spinal cord function could be evaluated using these changes.5. In clinical hypotensive anethesia, the blood pressure is generally reduced by 30%. In this range, this method is safe in terms of spinal cord function evaluated by spinal cord blood flow and spinal evoked potentials. Less

我们从脊髓血流量和脊髓诱发电位的角度评价了临床上常用的降压药物维持降压对脊髓的影响，并注意脊髓的自我调节。(方法)成年兔在GOE麻醉下监测动脉压。用前列腺素E_1和硝酸甘油诱导低血压。在收缩压维持在正常血压的30%后，停止给药。血压恢复后，血压再次下降50%和70%，并连续测定脊髓血流量和SPE。应用前列腺素E_1分别将血压降低30%和50%，进行脊柱牵张，观察松解后脊髓血流量和脊髓诱发电位的变化。用激光多普勒法测定脊髓血流量。作为脊髓诱发电位，作为…经L4/5和Th9/10椎板间隙置入硬膜外电极可记录到更多的下降电位。结果：1.硝酸甘油、前列腺素两种不同作用机制的药物维持的降压状态下，脊髓血流量均减少，但与血压下降率无关。结论：1.每种药物停药后脐血流量恢复较好，降压率较低。由于脊髓诱发电位随血压的变化而改变，弱刺激(3T)后第二电位波幅的改变最能反映脊髓血流量的变化。脊柱牵引后，血压下降30%或50%，脊髓血流量进一步减少，但两种降压率之间的减少没有显著差异。松解脊柱牵引后，脊髓血流量在30%减少状态下恢复，但在50%减少状态下进一步减少。下降弱刺激后第一电位的波幅变化与第二电位弱刺激后的变化相似。利用这些变化可以评估脊柱牵张对脊髓功能的影响。在临床降压麻醉中，血压一般降低30%。在此范围内，根据脊髓血流量和脊髓诱发电位评估脊髓功能，该方法是安全的。较少