德斯弗在脊髓损伤患者的功能结果中的作用,这些患者接受了上肢神经转移手术
Muhammad I Kaleem1, Arbi B Abdallah2, Saad Javeed1
1Neurological Surgery, Washington University School of Medicine, St. Louis, USA.
Cureus
|March 25, 2025
概括
这项研究表明,desflurane可能会改善脊髓损伤 (SCI) 患者的运动强度,这些患者接受神经移植手术,可能提供神经保护. 需要进一步的研究来证实这些发现在一个更大的患者群体.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 再生医学是一种再生医学.
背景情况:
- 挥发性麻醉剂在实验性脊髓损伤 (SCI) 模型中显示出神经保护作用.
- 挥发性麻醉剂对人类SCI患者神经学结果的影响尚不清楚.
- 外围神经移植是SCI后改善功能的一种手术选择.
研究的目的:
- 为了研究挥发性麻醉剂 (sevoflurane,desflurane) 与慢性宫SCI患者经历神经移植的功能结果之间的关联.
- 评估不同挥发性麻醉剂对手术后运动力恢复和功能评分的影响.
主要方法:
- 对经历神经转移 (2015-2019) 的宫SCI和上肢的成年患者的回顾性分析 (2015-2019).
- 主要结局:动力强度 (MRC尺度0-5). 二级结局:DASH,SHFT,MHQ分数. 这是第二级结局.
- 单变量和逻辑回归分析,以评估麻醉对术后48个月内运动强度的影响.
主要成果:
- 在最后的随访中,德斯夫兰组的运动力中位数显著增加 (3) 相比于塞沃夫兰组的运动力中位数 (1) (p=0.014).
- 在麻醉组之间的DASH,SHFT或MHQ得分中没有发现显著差异.
- 后勤回归确定了神经转移类型和手术前ASIA损伤量表等级作为运动功率改善的重要预测因素.
结论:
- 初步数据表明,在接受外围神经移植的SCI患者中,使用desflurane与改善运动强度之间存在关联.
- 这些发现表明,在临床前SCI研究中观察到的挥发性麻醉条件诱导的神经保护具有潜在的临床相关性.
- 在更大的队列中进一步验证和对分子机制的研究是转化应用的必要条件.
更多相关视频
05:09Author Spotlight: Neuromotor Control and Recovery of Diaphragm Function Following Cervical Spinal Hemisection in Rats
Published on: June 14, 2024
318
09:08A Neurosphere Assay to Evaluate Endogenous Neural Stem Cell Activation in a Mouse Model of Minimal Spinal Cord Injury
Published on: September 13, 2018
9.8K
相关概念视频
Skeletal Muscle Relaxants: Therapeutic Uses
445
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
445
Local Anesthetics: Clinical Application as Spinal Anesthesia
562
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
562
Flail Chest-II
151
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
151
Depolarizing Blockers: Pharmocokinetics
298
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
298
