Combined PGI2, indomethacin, and heparin improves neurological recovery after spinal trauma in cats

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✓ Anesthetized cats were subjected to standardized cervical spinal trauma produced by a modification of the Allen weight-dropping method. One hour after injury, animals were randomly allocated to one of three treatment groups, in which they received 1) saline, 2) naloxone, or 3) combined treatment, consisting of indomethacin, heparin, and prostacyclin (PGI2). Treatment was continued for 4 hours. Neurological function was evaluated weekly by a neurologist unaware of the treatment group, and was graded by means of a scale modified from that of Tarlov. Functional recovery in animals receiving combined drug therapy was significantly better than in saline-treated control animals, and was similar to that observed in naloxone-treated animals. The findings are discussed with respect to “blood-damaged tissue interaction” and may have implications both with regard to the pharmacological management of acute spinal injury and to the mechanism of action of opiate antagonists.

Article Information

Address reprint requests to: John M. Hallenbeck, M.D., Hyperbaric Medicine Program Center, Naval Medical Research Institute, Bethesda, Maryland 20814.

© AANS, except where prohibited by US copyright law.

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Figures

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    Mean arterial blood pressures measured at various times after experimental spinal cord injury. The hypertensive spike (mean level of 245 mm Hg for all groups) that occurred immediately after trauma is not depicted.

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    Effects of a combination treatment (PGI2, indomethacin, and heparin), naloxone, or saline on neurological recovery at 6 weeks after cervical spinal cord injury. The points represent the sums of forelimb and hindlimb neurological scores for individual animals; horizontal lines represent median scores.

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