Analysis of the Immuno-Neural-Endocrilogical Reaction to Anesthesia and Surgical Stress

(1)术中应激与免疫反应大手术过程中吸入麻醉本身或NLA麻醉的患者发生免疫抑制变化。硬膜外阻滞或内脏神经阻滞的全身麻醉可抑制这种变化。(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)交感神经系统手术应激、疼痛应激等应激对交感神经系统有影响。疼痛的定量分析可以通过监测血流和出汗的变化来评估。我们利用这种方法评估了交感神经系统对有害刺激的反应。(4)反射性交感神经营养不良（RSD）：我们的数据表明，无法治愈的RSD的自主神经障碍是由于对交感神经递质的超敏感而不是交感神经过度活跃。(5)激光：通过星状神经节照射，评价低反应级激光的效果。(6)细胞因子为了探讨手术应激下脾脏的作用，我们观察了脾静脉血和动脉血中血浆细胞因子的变化。这些数据表明，在手术应激下，脾脏大量产生IL-6。

(1) Stress during Surgery and Immunological ReactionImmuno-suppressive changes occured on the patients anesthetized with inhalation anesthesia itself or NLA during major surgery. General anesthesia with epidural block or splanchnic nerve block inhibit this changes.(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) Sympathetic Nerve SystemSome kinds of stress including surgical stress and pain stress influence Sympathetic Nerve System.Quantitative analysis of pain can be evaluated by monitoring changes in the blood flow and sweating. We utilized this method and evaluated the sympathetic nerve system responce to noxious stimulation.(4) Reflex Sympathetic Dystrophy (RSD)Our data suggest that the autonomic disturbance in incurable RSD are due to supersensitivity to sympathetic neurotransmitters rather than due to sympathetic overactivity.(5) LaserWe evaluated the effect of low-reactive level laser by irradiateing to stellate ganglion.(6) CytokineTo examine the role of spleen under the surgical stress, we investigated the changes of plasma cytokine levels in the splenic vein blood and the arterial blood. The data suggested that the spleen produces intensively IL-6 under surgical stress.