Postoperative Stroke after Spinal Anesthesia and Responses of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine in Rats
<p>Experimental setup and animals used in each group in this study.</p> "> Figure 2
<p>(<b>a</b>) Demonstration of lodging of the tip of the catheter (orange arrow) in the subarachnoid space below the middle portion of L6 vertebra. (<b>b</b>) Representative examples of myelographic examination before (1) and after intrathecal administration of four successive doses of contrast medium, given at 40 (2), 60 (3), 80 (4) or 100 (5) μL. Note that all demarcations denote levels of the spinal cord: the lower yellow arrows mark the location of the tip of the catheter, and the upper yellow arrows indicate the highest points reached by the enhanced roentgenological images. CM: conus medullaris. (<b>c</b>) Scattered plots showing the extent of dispersion in the spinal cord of contrast medium on intrathecal administration at 40, 60, 80 or 100 μL. Values are mean ± SEM of seven animals.</p> "> Figure 3
<p>Illustrative examples of real-time and online recording of common phasic changes in mean arterial pressure (MAP), heart rate (HR), power density of the low-frequency component in systolic blood pressure spectrum (BLF), baroreflex sensitivity (BRS) or baroreflex effectiveness index (BEI), simultaneous with carotid blood flow (CBF) in Group 2 animals (<b>a</b>); or concurrent with tissue perfusion (Tissue Flow), tissue oxygen tension (PO<sub>2</sub>) or tissue temperature in the cerebral cortex in Group 3 animals (<b>b</b>) on intrathecal administration of 80 μL of bupivacaine (at arrow).</p> "> Figure 4
<p>Common response patterns of MAP, HR, BLF, BRS and CBF or tissue perfusion, PO<sub>2</sub> or temperature in the cerebral cortex to intrathecal administration of 80 μL of bupivacaine. Note that values for MAP, HR, BLF and BRS are mean ± SEM of 33 animals (17 from Group 2 plus 16 from Group 3); values for CBF are mean ± SEM of 17 animals from Group 2; and values for tissue perfusion PO<sub>2</sub> or temperature in the cerebral cortex are mean ± SEM of 16 animals from Group 3. * <span class="html-italic">p</span> < 0.05 versus data obtained under basal conditions in the post hoc Dunnett multiple-range analysis; <sup>+</sup> <span class="html-italic">p</span> < 0.05 versus data obtained during Phase I in the post hoc Tukey multiple-range analysis.</p> "> Figure 5
<p>Common (<b>a</b>) and anomalous (<b>b</b>) response patterns of BEI to intrathecal administration of 80 μL of bupivacaine. Values for (<b>a</b>) are mean ± SEM from 33 animals (17 from Group 2 plus 16 from Group 3); and values for (<b>b</b>) are mean ± SEM of 15 animals (7 from Group 2 plus 8 from Group 3). * <span class="html-italic">p</span> < 0.05 versus data obtained under basal conditions in the post hoc Dunnett multiple-range analysis. (<b>c</b>) Insignificant changes of BEI under isoflurane alone without spinal anesthesia. Values are mean ± SEM of 14 animals from Group 4. No significance among all groups (<span class="html-italic">p</span> > 0.05).</p> "> Figure 6
<p>Zoomed-in view of 40 min of real-time recording from <a href="#biology-10-00617-f002" class="html-fig">Figure 2</a>a of Phase I changes in MAP, BLF and CBF on intrathecal administration of 80 μL of bupivacaine (at arrow). Note that the red and green dotted lines denote time points at which reduction of BLF power and MAP or CBF commenced.</p> "> Figure 7
<p>Illustrative examples of real-time and online recording of anomalous phasic changes in MAP, HR, BLF, BRS or BEI, simultaneous with CBF in Group 2 animals (<b>a</b>); or concurrent with tissue perfusion, PO<sub>2</sub> or temperature in the cerebral cortex in Group 3 animals (<b>b</b>) with intrathecal administration of 80 μL of bupivacaine (at arrow).</p> "> Figure 8
<p>Anomalous response patterns of MAP, HR, BLF, BRS and CBF or tissue perfusion, PO<sub>2</sub> or temperature in the cerebral cortex to intrathecal administration of 80 μL of bupivacaine. Note that values for MAP, HR, BLF and BRS are mean ± SEM of 15 animals (7 from Group 2 plus 8 from Group 3); values for CBF are mean ± SEM of 7 animals from Group 2; and values for tissue perfusion, PO<sub>2</sub> or temperature in the cerebral cortex are mean ± SEM of 8 animals from Group 3. * <span class="html-italic">p</span> < 0.05 versus data obtained under basal conditions in the post hoc Dunnett multiple-range analysis; + <span class="html-italic">p</span> < 0.05 versus data obtained during Phase I in the post hoc Tukey multiple-range analysis.</p> "> Figure 9
<p>Insignificant changes of MAP, HR, BLF, BRS and CBF or tissue perfusion, PO<sub>2</sub> or temperature in the cerebral cortex under 1.5% isoflurane anesthesia alone. Note values for MAP, HR, BLF and BRS are mean ± SEM of 14 animals (7 from Group 4 CBF experiments plus 7 from Group 4 tissue perfusion experiments); values for CBF are mean ± SEM of 7 animals; and values for tissue perfusion, PO<sub>2</sub> or temperature in the cerebral cortex are mean ± SEM of 7 animals. No significance among all groups (<span class="html-italic">p</span> > 0.05).</p> ">
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Ethics Statement
2.2. Patients
2.3. Animals
2.4. Subarachnoid Catheterization
2.5. Intrathecal Administration
2.6. Myelogram
2.7. General Preparation for Physiological Experiments
2.8. Measurement of Blood Pressure, Heart Rate and Spontaneous Baroreflexes
2.9. Measurement of Carotid Blood Flow
2.10. Measurement of Microvascular Perfusion, Tissue Oxygen Level and Temperature in the Cerebral Cortex
2.11. Sample Size Calculation
2.12. Statistical Analyses
3. Results
3.1. Part 1. Patients
3.2. Part 2. Animals
3.2.1. Experimental Setup
3.2.2. Distribution of Contrast Medium in Spinal Subarachnoid Space after Intrathecal Administration
3.2.3. Common Response Pattern of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine
3.2.4. Anomalous Response Pattern of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine
3.2.5. Insignificant Changes in Carotid or Cerebral Blood Flow and Baroreflex Functionality under Isoflurane Anesthesia
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Poon, Y.-Y.; Liu, Y.-W.; Huang, Y.-H.; Chan, S.H.H.; Tsai, C.-Y. Postoperative Stroke after Spinal Anesthesia and Responses of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine in Rats. Biology 2021, 10, 617. https://doi.org/10.3390/biology10070617
Poon Y-Y, Liu Y-W, Huang Y-H, Chan SHH, Tsai C-Y. Postoperative Stroke after Spinal Anesthesia and Responses of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine in Rats. Biology. 2021; 10(7):617. https://doi.org/10.3390/biology10070617
Chicago/Turabian StylePoon, Yan-Yuen, Yueh-Wei Liu, Ya-Hui Huang, Samuel H. H. Chan, and Ching-Yi Tsai. 2021. "Postoperative Stroke after Spinal Anesthesia and Responses of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine in Rats" Biology 10, no. 7: 617. https://doi.org/10.3390/biology10070617
APA StylePoon, Y. -Y., Liu, Y. -W., Huang, Y. -H., Chan, S. H. H., & Tsai, C. -Y. (2021). Postoperative Stroke after Spinal Anesthesia and Responses of Carotid or Cerebral Blood Flow and Baroreflex Functionality to Spinal Bupivacaine in Rats. Biology, 10(7), 617. https://doi.org/10.3390/biology10070617