摘要
目的 观察星状神经节阻滞（SGB）对福尔马林致痛兔脊髓P物质（SP）含量的影响,探讨其治疗疼痛的可能机制。方法 健康成年日本大耳白兔在无菌操作下暴露右侧星状神经节,置入并固定硬膜外导管,使其一端开口位于星状神经节附近,另一端自颈背部穿出。置管1周后,选择恢复健康者19只随机分为三组:假手术组（A组）5例、SGB组（B组）和对照组（C组）各7例。A组直接麻醉后灌注固定取脊髓颈段 6～8（C6-8）和胸段 6—8（T6-8。）;B组和 C组用福尔马林皮下注射法建立急性疼痛模型,致痛lh后B组经导管注入0.25％布比卡因0.5ml, C组用等量生理盐水。观察lh后,同A组一样灌注固定取脊髓。用免疫组织化学方法检测脊髓SP含量的变化。结果 SP免疫阳性反应物集中分布在脊髓背角I、Ⅱ层。B组和C组脊髓颈段SP的光密度（OD）值与A组相比均降低（P<0.05、P<0.01）;B组脊髓颈段SP的OD值较C组显著升高（P<0.05）。三组间脊髓胸段内SP的 OD值无明显差别（P>0.05）。结论 上肢皮下注射福尔马林可引起兔脊髓颈段 SP含量降低;星状神经节阻滞可部分逆转这种现象,使SP含量升高;BP含量升高可能是其治疗疼痛性疾病的脊髓机制之一。
Objective To investigate the effect of stellate ganglion block (SGB) on substance P of spinal cord in rabbits following formalin stimulation and the possible mechanism. Methods Rabbits of both sexes weighting 2.5-3.0 kg were anesthetized with 20% urethane 1 g·kg-1 . Spontanous breathing was maintained. Right stellate ganglion was exposed aseptically. An epidural catheter was fixed with one end placed closed to stellate ganglion and the other end outside the neck through a hole on the skin for administration of drugs. One week later, nineteen healthy rabbits were randomly divided into three groups: sham operation group (group A, n = 5), SGB group (group B, n=7) and control group (group C, n = 7) . In group B and group C, 3 % formalin 0.2 ml was injected subcutaneously into plantar region of the right paw. Pain response was observed. 1h after formalin injected, 0.25% bupivacaine 0.5 ml was injected through the catheter in group B while normal saline 0.5 ml was injected in group C. The effect of SGB was confirmed by ptosis and miosis. 1h after using of bupivacaine or normal saline, rabbits were deeply anesthetized and chest was opened, 1 000 ml of normal saline was infused via left ventricle then followed by 2000-2500 ml of 4% paraformaldehyde in 0.1mol/L phosphate buffer pH7.4 infusion for fixation of tissue, 60 min later spinal cord of cervical 6-8(C6-8) and thoracic 6-8(T6-8 ) were removed. In group A the spinal cord were extracted similar to the other groups. The content of SP in spinal cord use immumohistochemistry technique of strept avidin biotin enzyme complex (SABC) to display. Results Immunoreaction of SP were distributed mainly in lamina Ⅰ and Ⅱ of dorsal horn of spinal cord. Compared with group A, the optical density(OD) of SP in cervical slices were decreased significantly in group B and group C(P<0.05, P<0.01); the OD of SP in cervical slices were increased in group B compared withgroup C( P < 0.05) . The OD of SP in thoracic slices were no different between the three groups(P > 0.05 ). Conclusions The content of SP in spinal cord decreased significantly after subcutaneous injection of formalin in rabbits. SGB can reverse the phenomena partly and increase the content of SP of cervical spinal cord in rabbits following formalin stimulation. This may be the possible mechanism of analgesia provided by SGB.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2002年第5期301-304,共4页
Chinese Journal of Anesthesiology
