The role of androgen on brain protection by inhalation anestheticsduring cerebral reperfusion

围手术期脑缺血的诊断是困难的，但脑梗死的发生是致命的。因此，预防此类事件的发生对麻醉管理非常重要。脑梗死的发病率存在性别差异，一般而言，女性脑梗死的发病率低于男性。这表明雌激素强烈参与了这一机制。另一方面，关于雄激素在缺血事件中的作用的信息很少。已有文献报道，吸入麻醉剂预处理的神经保护作用仅见于雄性动物，雌性动物未见。吸入麻醉剂对脑缺血的保护作用可能存在性别差异。然后，我们打算探讨雄激素和七氟醚之间的相互作用，对脑保护作用。首先，为了评价脑血管内皮功能， ...更多信息 在缺血/再灌注中，我们使用与Sprague-Dawley大鼠大脑中动脉闭塞模型相关的闭合颅窗制备。本实验采用局部应用乙酰胆碱的方法评价脑缺血/再灌注前后脑血管内皮功能的变化，但七氟醚吸入对脑缺血/再灌注引起的血管内皮功能障碍无明显的减轻作用，同时测定了主动脉阻断和开放后脊髓组织氧分压（PsptO_2）的变化。在麻醉家兔中，我们准备使用组织PO 2监测测量主动脉阻断后的PsptO 2。在实验中，我们将18只动物分为3组，（d）对照组;（e）雌激素（17β雌二醇：20μg）组n = 6;（f）氟维司群预处理（1 mg/kg）组n =6。给予17β雌二醇可改善主动脉阻断后20 min和主动脉开放后0、2、5 min PsptO 2值的恶化。氟维司群预处理降低了改善。少

The diagnosis of perioperative cerebral ischemia is difficult, but the onset of cerebral infarction is fatal. Thus, the prevention of such event is very important for anestheticmanagement. Gender differences are observed in the incidence of cerebral infarction, and generally the incidence of cerebral infarction is less in females than males. It is suggested that the estrogen is strongly involved in this mechanism. On the other hand, there is little information about the role of androgen regarding ischemic events. It hasbeen reported that neuroprotective effect through preconditioning induced by inhalation anesthetic was found only in males, and not seen in females. There is a possibility that the gender difference is involved in the protective effect of inhaled anesthetic for the brain ischemia. Then we intended to investigate the interaction between androgen and sevoflurane regarding cerebral protective effect. Firstly, in order to evaluate thecerebral endothelial function following i … More schemia/reperfusion, we used the closed cranial window preparation associated with the middle cerebral artery occlusion model in the Sprague-Dawley rat. To evaluate the cerebrovascular endothelial function before and after cerebral ischemia/reperfusion, topical administration of acetylcholine could be applied.Unfortunately, by the inhalation of sevoflurane, the attenuation effect of vascular endothelial dysfunction caused by ischemia/reperfusion was not observed.Additionally, we evaluated the tissue oxygen partial pressure of spinal cord (PsptO2) following aortic cross-clamping and -unclamping. In anesthetized rabbits, we prepared for measurement of PsptO2 following aortic cross-clamping using tissue PO2 monitoring. In the experiment, we allocated 18 animals into 3 groups,(d) control group; n=6,(e) estrogen (17β estradiol: 20μg) group; n=6,(f) fulvestrant pretreatment (1mg/kg) groupn=6. Administration of 17β estradiol improved deterioration of the values in PsptO2 at 20 min after aortic cross-clamping and 0, 2, 5 min after aortic unclamp. The improvement was diminished by pretreatment of fulvestrant. Less