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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 10minutes 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.