Propofol application combined with ischemic preconditioning for aortic occlusion-induced spinal cord injury

摘要

BACKGROUND:Propofol combined with ischemic preconditioning (IPC) could prevent spinal ischemia/reperfusion injury.However, the effect of this combination remains poorly understood.OBJECTIVE:To measure neuroprotection of IPC in combination with propofol in a rabbit model of aorta occlusion-induced spinal injury.DESIGN, TIME AND SETTING:A randomized, controlled, animal experiment was performed at the Laboratory of Anesthesiology, Wuhan University and Central Laboratory of the First Clinical Medical College, China Three Gorges University, from October 2006 to April 2008.MATERIALS:Propofol was purchased from AstraZeneca, UK; malondialdehyde (MDA) and superoxide dismutase (SOD) kits were purchased from Nanjing Jiancheng Bioengineering Institute, China.METHODS:A total of 32 male, Japanese White rabbits, were randomly assigned to model, IPC, propofol, and combination groups, with eight rabbits in each group, using 2×2 factorial experimental design.Spinal ischemia/reperfusion injury was induced by abdominal aorta occlusion for 40 minutes and reperfusion for 7 days.The IPC group was subjected to IPC treatment for 30 minutes prior to occlusion; the propofol group was treated with propofol for 10 minutes before occlusion; and the combination group underwent IPC treatment for 30 minutes and propofol for 10 minutes prior to occlusion.MAIN OUTCOME MEASURES:Serum MDA levels and SOD activity were detected 35 minutes prior to occlusion, immediately after reperfusion, and 60 minutes and 7 days after reperfusion, respectively.Rabbit hind limb nerve function and spinal pathological changes following injury were observed, and spinal neuronal apoptosis was determined using the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling method.RESULTS:Serum MDA levels, spinal neuronal apoptosis, and palsy incidence following injury were greatest in the propofol group, followed by the IPC and combination groups (P<0.01), while SOD activity and hind limb neurological scores were greatest in the combination group, followed by the IPC and propofol groups.Spinal cord injury in the combination group was slight (P<0.01).CONCLUSION:IPC and propofol treatment resulted in a synergistic effect for treating spinal ischemia/reperfusion injury.Combined application was superior to IPC or propofol treatment, suggesting that the protection of spinal cord injury may relate with anti-peroxidation.