Analysis of Immunological Changes during Anesthesia and Surgery

(1)术中应激与免疫反应硬膜外阻滞或内脏神经阻滞全麻可抑制吸入麻醉本身或NLA麻醉下大手术时的免疫抑制变化。(2)术中应激与血浆皮质醇浓度全麻硬膜外阻滞未抑制上腹部手术中血浆皮质醇浓度的升高。足底神经阻滞可明显抑制血浆皮质醇浓度的升高。(3)血小板聚集围手术期应激可能对血小板聚集有相对影响，目前尚无合适的血小板功能评价方法。我们的结论是，新的血小板聚集试验是必要的。(4)交感神经系统交感神经系统具有将压力（包括疼痛压力）引起的冲动从下丘脑传导到内分泌或免疫系统的功能。疼痛的定量分析可以通过监测皮肤血流量和出汗的变化来评估。我们利用这种方法评估了手术过程中交感神经系统对疼痛刺激的反应。(5)反射性交感神经营养不良（RSD）我们对20例RSD患者进行了新的治疗方法和现行治疗方法的评估。我们展示了新方法如何评估RSD患者的疼痛，利用定量分析来监测皮肤血流量的变化。(6)星状神经节阻滞（SGB）星状神经节分布于上肢、面部和头部。我们评价了SGB对外周血循环的影响。

(1) Stress during Surgery and Immunological ReactionGeneral anesthesia with epidural block or splanchnic nerve block inhibit the immuno-depressive changes during major surgery anesthetized with inhalation anesthesia itself or NLA.(2) Stress during Surgery and Plasma Cortisol ConcentrationGeneral anesthesia with epidural block never depressed the increase of plasma cortisol concentration during upper abdominal surgery. The planchnic nerve block depressed the increase of plasma cortisol concentration significantly.(3) AggregationNevertheless, perioperative stress might have a relative influence on Platelet Aggregation, we have no adeguate method for evaluating the platelate function. We concluded that the new platelate aggregation test is essential.(4) Sympathetic Nerve SystemSympathetic Nerve System has the function to conduct an impulse from the hypothalamus to the endocrine or immune system caused by stress, including pain stress. Quantitative analysis of pain can be evaluated by monitoring changes in the skin blood flow and sweating. We utilized this method and evaluated the sympathetic nerve system responce to pain stimulation during surgery.(5) Reflex Sympathetic Dystrophy (RSD)The new therapeutic procedure in our pain relief clinic and prevailing tharapy were evaluated in twenty RSD patients. We showed how the new method evaluated the pain in RSD patients, utilizingguantitive analysis by monitoring changes in the skin blood flow.(6) Stellate Ganglion Block (SGB)Stellate Ganglion distributed to the upper extrimities, face and head. We evaluated the influence of SGB to the periferal blood circulation.