异氟醚和地尔硫卓联合作用对人精子运动功能的影响

目的:观察异氟醚和地尔硫卓联合应用在体外对人精子运动功能的影响并探讨其机制。方法:选取10例活力正常的精液标本,每例精液均一式9份,1份作为对照,其余8份分别经过不同浓度地尔硫卓单独或联合应用4.2%异氟醚处理1 h,采用计算机辅助精液分析系统观察精子运动功能的变化情况。结果:①与对照组相比,0.01~1 g/L地尔硫卓均可显著降低精子活力,并呈浓度依赖性降低,当地尔硫卓浓度升高至1 g/L,精子活力显著降低。②将不同浓度的地尔硫卓和4.2%异氟醚联合应用后与同浓度下地尔硫卓组对比,0.01 g/L地尔硫卓与异氟醚联合用药时精子的活力显著升高,0.04 g/L地尔硫卓与异氟醚联合用药时精子的活力无显著差别,0.2 g/L地尔硫卓与异氟醚联合用药时精子的活力显著降低,1 g/L地尔硫卓联合用药时精子的活力无显著差别。结论:异氟醚兴奋精子运动的作用可能与精子的钙离子通道有关,当此兴奋作用被地尔硫卓完全阻断时,异氟醚对精子的运动则表现出抑制作用。     

不同吸入麻醉药对人精子运动功能和体外获能的影响

目的 探讨不同吸入麻醉药对人精子运动功能和体外获能的影响.方法 成年男性精液经Percoll梯度离心法处理后,沉淀精子置于人精子体外获能培养基,调节精子密度(30～50)×106/ml,随机分为5组(n=7):对照组(C组)正常培养,2%、4%七氟醚组(SEV1、2组)和1.1%、2.2%异氟醚组(ISO1、2组)在37℃孵箱中分别暴露于2%、4%七氟醚和1.1%、2.2%异氟醚5 h,采用计算机辅助精子分析系统评价精子运动功能,记录精子运动活力[(a+b)%]、曲线速度(VCL)、直线速度(VSL)、平均速度(VAP)和头部侧向运动平均振幅(ALH),采用金霉素荧光染色技术评价精子体外获能情况.计算吸入麻醉药组各指标的相对抑制率.结果 与C组比较,SEV1组、SEV2组和ISO2组(a+b)%、VCL、VSL、VAP降低,SEV2组ALH、SEV2组和ISO1、2组精子获能程度降低(P＜0.05);与SEV1组比较,SEV2组(a+b)%、VCL、VSL、VAP降低,ISO1组(a+b)%、VCL、VSL、VAP的相对抑制率降低(P＜0.05);与ISO1组比较,ISO2组(a+b)%、VCL、VSL、VAP降低(P＜0.05);与SEV2组比较,ISO2组(a+b)%、VCL、VSL、VAP和ALH的相对抑制率降低(P＜0.05).结论 七氟醚和异氟醚均可呈剂量依赖性地抑制人精子运动功能和体外获能;七氟醚抑制精子运动功能的作用较异氟醚强.     

静吸复合麻醉下七氟醚与异氟醚对颅内压的影响

目的:在颅内顺应性正常神经外科病人,观察1.0 MAC七氟醚与异氟醚对颅内压的影响。方法:垂体瘤或颅咽管瘤手术病人16例,随机分为两组:A组为咪唑安定 芬太尼 1.0 MAC异氟醚;B组为咪唑安定 芬太尼 1.0 MAC七氟醚。选择L_(3～4)行蛛网膜下腔穿刺。麻醉诱导采用芬太尼-咪唑安定-阿曲库铵。插管后维持稳定30分开始吸入七氟醚(或异氟醚)。分别于麻醉前、吸入麻醉药前、达预定呼气末浓度30分内观察监测指标。结果:1.0 MAC七氟醚和异氟醚均可显著降低脑灌注压,异氟醚作用较强。吸入1.0 MAC七氟醚后颅内压首先呈显著性下降,15分后回复至基础水平。吸入1.0 MAC异氟醚后颅内压无显著性变化。结论:在颅内顺应性正常患者,1.0 MAC七氟醚和异氟醚均可安全用于神经外科麻醉。     

七氟醚、异氟醚和地氟醚对神经外科手术患者经颅电刺激运动诱发电位的影响

目的 比较七氟醚、异氟醚和地氟醚对神经外科手术患者经颅电刺激运动诱发电位(MEPs)的影响.方法 择期行神经外科手术患者60例,年龄18～64岁,ASA分级Ⅰ或Ⅱ级.随机分为3组(n=20):七氟醚组、异氟醚组和地氟醚组.监测BIS值和经颅电刺激MEPs.调节七氟醚、异氟醚和地氟醚吸入浓度,使其呼气末浓度分别达到0.50、0.75、1.00和1.30 MAC,每一浓度均维持15 min,视为稳态呼气末浓度.于给予吸入麻醉药前(基础状态)和达到各稳态呼气末浓度(T1-4)时,记录MEPs的波幅和潜伏期以及BIS值.记录MEPs波形记录失败情况.结果 与七氟醚组和异氟醚组比较,地氟醚组T1.2时波幅和BIS值降低,T1-4时潜伏期延长(P＜0.05);七氟醚组和异氟醚组各指标比较差异无统计学意义(P＞0.05).七氟醚组、异氟醚和地氟醚组基础状态、T1、T2时的记录失败率均为0;T3时记录失败率分别为0、5%和20%,三组比较差异无统计学意义(P＞0.05);T4时记录失败率分别为5%、20%和45%,与七氟醚组和异氟醚组比较,地氟醚组记录失败率升高(P＜0.05);七氟醚组和异氟醚组比较差异无统计学意义(P＞0.05).结论 地氟醚对神经外科手术患者经颅电刺激MEPs的抑制作用强于七氟醚和异氟醚.术中行MEPs监测时,七氟醚和异氟醚适宜的呼气末浓度为1.00 MAC,地氟醚为0.75～1.00 MAC.     

吸入麻醉药对兔肾交感神经活动的影响

目的比较吸入麻醉药对交感神经活动和血液动力学的影响。方法18只兔被随机分为三组:安氟醚组、异氟醚组和地氟醚组。兔麻醉、肌松和人工通气后,暴露肾交感神经并记录其电生理活动。分别吸入呼气末浓度为0.8%、1.6%、2.4%、3.2%安氟醚,0.6%、1.2%、1.8%、2.4%异氟醚,或3.0%、6.0%、9.0%、12.0%地氟醚。结果交感神经活动在兔吸入2.4%安氟醚、0.6%异氟醚和6.0%地氟醚时分别增加到44%、36%和32%,当进一步增加吸入麻醉药的浓度则抑制肾交感神经活动。血压随着吸入麻醉药浓度的增加不断下降而心率除了2.4%异氟醚诱发心率减慢外无明显变化。结论安氟醚、异氟醚和地氟醚具有双向作用,低浓度兴奋交感神经,高浓度抑制交感神经活动和降低血压。     

地氟醚、七氟醚和异氟醚对犬血液动力学和氧供需平衡的影响

目的　采用连续温度稀释法观察不同浓度地氟醚对血液动力学和氧供需平衡的影响 ,并与七氟醚和异氟醚比较。方法　犬 18只 ,1.5 %硫喷妥钠 2 0 mg/ kg、阿曲库胺 0 .8mg/ kg麻醉诱导 ,气管插管后机械通气。左股静脉穿刺置入 7.5 F的六芯肺动脉漂浮导管 ,接 CCO/ SvO2 监测仪 ,连续测定并计算血液动力学及氧供需平衡各项指标。操作完成后平稳 1小时 ,取基础指标。然后随机依次吸入 0 .7、1.2和 1.7MAC的地氟醚、七氟醚或异氟醚 ,呼气末浓度达预定值后稳定 2 0分钟 ,记录各指标 ,再增加吸入浓度达下一个预定浓度。结果　 MAP、SVR和 CO在三组均呈剂量依赖性下降 ,地氟醚和异氟醚组 HR明显增快 ,七氟醚组 HR则明显减慢 ,异氟醚组 1.7MAC时 VO2 增加 ,DO2 和Sv O2 下降。结论　地氟醚对循环功能和氧供需平衡的影响与异氟醚相似 ,与七氟醚则有所不同     

地氟醚、七氟醚和异氟醚预处理对缺氧/复氧心肌细胞损害的保护作用

目的　研究地氟醚、七氟醚和异氟醚预处理对心肌细胞缺氧／复氧损害的保护作用。方法　原代培养乳鼠心肌细胞，随机分为对照、单纯缺氧／复氧及 １．５ＭＡＣ地氟醚、七氟醚和异氟醚预处理５组。实验结束测定乳酸脱氢酶（ＬＤＨ）和肌酸激酶（ＣＫ）活性、细胞存活和凋亡率。结果　与对照组比，单纯缺氧／复氧使ＬＤＨ、ＣＫ和细胞凋亡率升高及细胞存活率显著下降（Ｐ＜０．０１）；１．５ＭＡＣ地氟醚、七氟醚和异氟醚预处理显著减轻ＬＤＨ、ＣＫ和细胞凋亡率升高及细胞存活率下降，其中七氟醚减轻作用最强。结论　地氟醚、七氟醚和异氟醚预处理对心肌细胞缺氧／复氧损害有一定的保护作用，七氟醚的保护作用可能更强。     

异氟醚和七氟醚对老年患者术后认知功能的影响

目的观察异氟醚和七氟醚麻醉对老年患者术后12个月认知功能和血清β淀粉样蛋白(β-amyloid,Aβ)浓度的影响。方法选择全麻下行腹部手术患者77例,男43例,女34例,年龄65~75岁,ASAⅠ~Ⅲ级,采用随机数字表法分为两组:异氟醚组(I组,n=32)和七氟醚组(S组,n=45)。采用简易精神状态量表(mini-mental state examination,MMSE)于术前1 d、术后3 d和术后12个月进行认知功能评分。同时留取患者血清,于以上时点测定Aβ40和Aβ42浓度。结果术后3 d I组和S组的MMSE评分明显低于术前(P0.05),且I组明显低于S组(P0.05);术后12个月I组和S组POCD发生率差异无统计学意义[13例(40.6%)vs 15例(33.3%)]。两组不同时点血清Aβ42和Aβ40浓度差异无统计学意义。结论七氟醚对近期认知功能的影响小于异氟醚,但长期的影响可能是一致的;两者对患者术后12个月血清β淀粉样蛋白浓度无影响。     

地氟醚,七氟醚和异氟醚对原代培养肝细胞增殖及分泌白蛋白？…

目的：本研究采用＾３Ｈ－ＴｄＲ掺入方法，观察地氟醚、七氟醚和异氟醚对肝细胞增殖和分泌白蛋白功能的影响，旨在从细胞生物学水平探讨卤族吸入全麻药肝毒性的作用机制。方法：肝细胞分离培养，经地氟醚、七氟醚或异氟醚作用后，固相膜片法测定肝细胞增殖功能。ＥＬＩＳＡ法测定培养液中Ａｌｂ分泌量。结果：地氟醚组在临床剂量和超临床剂量对肝细胞增殖功能和Ａｌｂ分泌均无明显影响，七氟醚和异氟醚组在临床剂量对增殖和Ａｌｂ分     

小儿七氟醚和异氟醚快速吸入诱导的比较

目的:比较小儿使用高浓度七氟醚和异氟醚加氧化亚氮快速吸入诱导的区别。方法:38例4～11岁,未使用术前药小儿随机分为二组,七氟醚组(n=20),吸入5％七氟醚,60％氧化亚氮;异氟醚组(n=18)吸入3.5％异氟醚,60％氧化亚氮。观察两组小儿采用快速吸入诱导方法时,睫毛反射和疼痛反应消失时间,以及药物的刺激性和诱导平稳程度的区别;同时观察两种方法对小儿循环功能的影响。结果:七氟醚组的诱导效果较为满意,其睫毛反射时间,疼痛反应消失时间均明显快于异氟醚组,分别为63.45±16.27(秒),189.40±28.70(秒)和75.82±22.60(秒),231.62±77.74(秒)(P<0.01);异氟醚对气道的刺激性较大,小儿吸入时躲闪,咳嗽,喉痉挛,兴奋以及分泌物增加的发生率明显高于七氟醚组;两组吸入诱导对小儿的血压无明显的影响。结论:小儿使用高浓度七氟醚吸入诱导是较为理想的麻醉诱导方法之一,与异氟醚比较,其吸入诱导平稳,对气道的刺激性较小,诱导时间明显缩短。     

Effects of exposure to new inhalational anesthetics on spermatogenesis and sperm morphology in rabbits

The effects of chronic exposure to new inhalation anesthetics (sevoflurane and isoflurane) on spermatogenesis and sperm morphology were examined in 23 rabbits, randomly divided in 3 groups. Rabbits received 20 exposure hours (four hours/day x 5 days), as follows: group I: 2.3% (1.2 MAC) sevoflurane + 2L/min oxygen, group II: 1.3% (1.2 MAC) isoflurane + 2L/min oxygen, and group III (control): 2L/min oxygen. Semen was collected on the 12th, 19th, 26th, 33rd, and 41st days of exposure. Sperm concentration, motility and morphological changes were evaluated. On the 41st day, testicular biopsies were taken and observed with light microscopy. Sperm concentration and motility significantly decreased in the sevoflurane and the isoflurane groups, compared to control. There were no significant changes in the control group. It is concluded that chronic exposure to the new inhalational anesthetics had negative effects on spermatogenesis and sperm morphology.     

The effect of sevoflurane on ciliary motility in rat cultured tracheal epithelial cells: a comparison with isoflurane and halothane

Halothane and isoflurane potently depress airway ciliary motility. We compared the effect of sevoflurane on ciliary beat frequency (CBF) with that of halothane and isoflurane using purified and cultured rat tracheal epithelial cells. Rat tracheal epithelial cells were isolated from adult male Sprague-Dawley rats to establish an air-liquid interface culture. Apical surfaces of the cells were exposed to a fresh gas containing humidified and warmed (25 degrees C) air (vehicle) with or without sevoflurane (0%-4%), halothane (0%-2%), or isoflurane (0%-2%). The images of motile cilia were videotaped and CBF was analyzed using a computer. Baseline CBF (= 100%) and CBF 30 min after the exposure were measured. CBF 30 min after vehicle exposure was 101% +/- 4% (mean +/- sd). Exposures to 0.25%-2% sevoflurane did not change CBF significantly, although exposures to 0.25%-2% halothane or isoflurane decreased CBF dose-dependently. CBFs 30 min after exposures to 2% of sevoflurane, halothane, and isoflurane were 97% +/- 9%, 56% +/- 14%, and 47% +/- 6%, respectively (n = 5 each). Sevoflurane 4% reduced CBF significantly but slightly (84% +/- 2%, n = 5). These results show that sevoflurane has a direct cilioinhibitory action but its action is much weaker than that of halothane and isoflurane in isolated rat tracheal epithelial cells.     

Catalase improves motility,vitality and DNA integrity of cryopreserved human spermatozoa

Cryopreservation of human spermatozoa offers a pre‐therapeutic possibility of preserving progenity in patients with testicular tumours. We aimed to investigate effects of cryopreservation and addition of catalase on sperm motility, vitality and DNA integrity in fresh and swim‐up spermatozoa. Semen samples were collected from 50 fertile men. Each sample was divided into two parts. First part was subdivided into two equal aliquots: both cryopreserved with and without catalase. The second part was subdivided into two equal aliquots: both processed by swim up and then cryopreserved with or without catalase. Semen analyses, sperm vitality and sperm DNA integrity were performed. Sperm concentration showed significant decrease while percentage of progressive motility, sperm vitality and % of DNA damage showed significant increase in processed and cryopreserved processed samples when compared with fresh and cryopreserved fresh samples. There was no significant difference in sperm concentration while there was significant increase in % of progressive motility and sperm vitality and % of DNA damage showed significant decrease in samples with catalase when compared with samples without catalase (either fresh or processed). Catalase supplementation (fresh and processed) during cryopreservation results in better post‐thawing percentage of progressive motility and percentage of sperm vitality and improved DNA integrity.     

Influence of tris(4-chlorophenyl)methanol, non-ortho PCB 77 and gamma-hexachlorocyclohexane on human sperm function in vitro

In recent years, there has been growing concern that environmental pollutants in general, and organochlorines in particular, adversely affect male fertility. Therefore, we investigated the effects of tris(4-chlorophenyl)methanol (TCPM), non-ortho PCB 77 and gamma-hexachlorocyclohexane (gamma-HCH, lindane) on human sperm functions in vitro. Human spermatozoa from healthy donors were washed in human tubular fluid medium containing 1% human serum albumin, filtered through glass wool and exposed to different concentrations of TCPM, PCB 77 or gamma-HCH. After incubation for 5 h at 37 degrees C and 5% CO(2), sperm vitality and the percentage of living acrosome-reacted spermatozoa were examined using triple stain technique. Total sperm motility was evaluated by computer-assisted sperm analysis (Stroemberg-Mika) after 5 h. For TCPM, total motility was additionally measured after 18 and 40 h. Different concentrations of PCB 77 and gamma-HCH did not alter the percentage of spontaneous living acrosome-reacted spermatozoa, vitality and total motility. TCPM dose-dependently altered sperm motility, vitality and acrosome reaction. The percentage of living acrosome-reacted spermatozoa was increased at overtly toxic concentrations. Therefore, it is suggested that unspecific acrosomal loss has been induced by degenerative processes. In conclusion, even high concentrations of PCB 77 and gamma-HCH did not affect human sperm functions in vitro. Only very high cytotoxic TCPM concentrations modulated spontaneous acrosome reaction and total motility. Therefore, in vivo effects on human sperm function seem to be unlikely. However, individual susceptibility has to be considered and little is known about additive and possible synergistic effects as other environmental pollutants with similar potencies have been found in the human male and female reproductive tract.     

七氟醚和异氟醚对罗库溴铵阻滞大鼠骨骼肌成人型乙酰胆碱受体的影响

目的 评价七氟醚和异氟醚对罗库溴铵阻滞大鼠骨骼肌成人型乙酰胆碱受体(ε-nAChR)的影响.方法 通过脂质体转染法构建表达ε-nAChR的HEK293细胞,采用全细胞膜片钳技术分别测定不同浓度七氟醚、异氟醚和罗库溴铵孵育后乙酰胆碱激动ε-nAChR的内向电流,拟合七氟醚、异氟醚和罗库溴铵浓度与ε-nAChR内向电流抑制率的浓度-效应曲线,计算3种药物抑制ε-nAChR内向电流的5％的浓度(IC5)、25％的浓度(IC25)和50％的浓度(IC50).分别用IC5、IC25和IC50七氟醚和异氟醚孵育重组HEK293细胞,然后加入IC25罗库溴铵共同孵育；用IC25七氟醚和异氟醚孵育重组HEK293细胞,然后用IC5、IC25、IC50罗库溴铵共同孵育；分别计算ε-nAChR内向电流抑制率.结果 IC5、IC25和IC50七氟醚或异氟醚与IC5和IC25罗库溴铵抑制ε-nAChR内向电流的效应呈协同作用,而与IC50罗库溴铵抑制ε-nAChR内向电流的效应呈相加作用；IC50七氟醚与IC25罗库溴铵抑制ε-nAChR内向电流的效应弱于异氟醚,而IC50七氟醚与IC25罗库溴铵抑制ε-nAChR内向电流的效应强于异氟醚,IC25七氟醚与IC5罗库溴铵抑制ε-nAChR内向电流的效应弱于异氟醚.结论 七氟醚或异氟醚与低浓度罗库溴铵阻滞大鼠骨骼肌ε-tAChR的效应呈协同作用,而与高浓度罗库溴铵的效应呈相加作用；低浓度七氟醚强化罗库溴铵阻滞ε-nAChR的效应弱于异氟醚,而高浓度七氟醚的效应强于异氟醚.     

In vitro effects of desflurane, sevoflurane, isoflurane, and halothane in isolated human right atria

BACKGROUND: Direct myocardial effects of volatile anesthetics have been studied in various animal species in vitro. This study evaluated the effects of equianesthetic concentrations of desflurane, sevoflurane, isoflurane, and halothane on contractile parameters of isolated human atria in vitro. METHODS: Human right atrial trabeculae, obtained from patients undergoing coronary bypass surgery, were studied in an oxygenated (95% O2-5% CO2) Tyrode's modified solution ([Ca2+]o = 2.0 mM, 30 degrees C, stimulation frequency 0.5 Hz). The effects of equianesthetic concentrations (0.5, 1, 1.5, 2, and 2.5 minimum alveolar concentration [MAC]) of desflurane, sevoflurane, isoflurane, and halothane on inotropic and lusitropic parameters of isometric twitches were measured. RESULTS: Isoflurane, sevoflurane, and desflurane induced a moderate concentration-dependent decrease in active isometric force, which was significantly lower than that induced by halothane. In the presence of adrenoceptor blockade, the desflurane-induced decrease in peak of the positive force derivative and time to peak force became comparable to those induced by isoflurane. Halothane induced a concentration-dependent decrease in time to half-relaxation and a contraction-relaxation coupling parameter significantly greater than those induced by isoflurane, sevoflurane and desflurane. CONCLUSIONS: In isolated human atrial myocardium, desflurane, sevoflurane, and isoflurane induced a moderate concentration-dependent negative inotropic effect. The effect of desflurane on time to peak force and peak of the positive force derivative could be related to intramyocardial catecholamine release. At clinically relevant concentrations, desflurane, sevoflurane, and isoflurane did not modify isometric relaxation.     

Comparison of the effects of sevoflurane, isoflurane and halothane on rat myocardium

The effects of sevoflurane on myocardial contraction and relaxation are poorly understood. Therefore, we studied the effects of equianaesthetic concentrations (0.5, 1, 1.5, 2 and 2.5 MAC) of sevoflurane, isoflurane and halothane on inotropic and lusitropic (myocardial relaxation) variables, and post-rest potentiation in rat left ventricular papillary muscles in vitro. Sevoflurane and isoflurane caused comparable concentration-dependent negative inotropic effects which were significantly lower than those induced by halothane (P < 0.05). Sevoflurane and isoflurane did not modify lusitropic variables under low or high load, whereas halothane showed a negative lusitropic effect at high concentrations. Halothane suppressed post-rest potentiation, whereas isoflurane and sevoflurane did not. Post-rest recovery was unaffected by halothane, isoflurane or sevoflurane at any concentration. Thus in rat myocardium, sevoflurane and isoflurane caused comparable negative inotropic effects, had no significant lusitropic effects and did not alter post-rest potentiation, suggesting that they did not significantly modify the functions of the sarcoplasmic reticulum.      

Characterization of the interactions between volatile anesthetics and neuromuscular blockers at the muscle nicotinic acetylcholine receptor

Volatile anesthetics enhance the neuromuscular blockade produced by nondepolarizing muscle relaxants (NDMRs). The neuromuscular junction is a postulated site of this interaction. We tested the hypothesis that volatile anesthetic enhancement of muscle relaxation is the result of combined drug effects on the nicotinic acetylcholine receptor. The adult mouse muscle nicotinic acetylcholine receptor (alpha(2), beta, delta, epsilon) was heterologously expressed in Xenopus laevis oocytes. Concentration-effect curves for the inhibition of acetylcholine-induced currents were established for vecuronium, d-tubocurarine, isoflurane, and sevoflurane. Subsequently, inhibitory effects of NDMRs were studied in the presence of the volatile anesthetics at a concentration equivalent to half the concentration producing a 50% inhibition alone. All individually tested compounds produced rapid and readily reversible concentration-dependent inhibition. The calculated 50% inhibitory concentration values were 9.9 nM (95% confidence interval [CI], 8.4-11.4 nM), 43.4 nM (95% CI, 33.6-53.3 nM), 897 microM (95% CI, 699-1150 microM), and 818 microM (95% CI, 685-1001 microM) for vecuronium, d-tubocurarine, isoflurane, and sevoflurane, respectively. Coapplication of either isoflurane or sevoflurane significantly enhanced the inhibitory effects of vecuronium and d-tubocurarine, especially so at small concentrations of NDMRs. Volatile anesthetics increase the potency of NDMRs, possibly by enhancing antagonist affinity at the receptor site. This effect may contribute to the clinically observable enhancement of neuromuscular blockade by volatile anesthetics. IMPLICATIONS: Isoflurane and sevoflurane enhance the receptor blocking effects of nondepolarizing muscle relaxants on nicotinic acetylcholine receptors.