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

麻醉和手术应激的免疫神经内分泌反应分析

• 批准号: 06454447
• 负责人: HOSOKAWA Toyoshi
• 金额: $ 4.86万
• 依托单位: KYOTO PREFECTURAL UNIVERSITY OF MEDICINE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06454447/
• 关键词: ANESTHESIA; ENDOCRINE SYSTEM; IMMUNE; SURGICAL STRESS; SYMPATHETIC NERVE SYSTEM; CENTRAL NERVOUS SYSTEM; PAIN; STELLATE GANGLION; 異常神経節; 手術; 疼痛; 星状神経節ブロック; 反射性交感神経性萎縮症

(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.

(1)手术应激与免疫反应大手术中，吸入麻醉本身或NLA麻醉的病人均出现免疫抑制变化。全身麻醉联合硬膜外阻滞或内脏神经阻滞可抑制这种变化。(2)手术应激与血浆皮质醇浓度上腹部手术时，全麻联合硬膜外阻滞不能抑制血浆皮质醇浓度的升高。平面神经阻滞可明显抑制血浆皮质醇浓度的升高。(3)交感神经系统包括手术应激和疼痛应激在内的一些应激会影响交感神经系统。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价了交感神经系统对伤害性刺激的反应。(4)反射性交感神经营养不良（RSD）我们的数据表明，在无法治愈的RSD的自主神经紊乱是由于交感神经递质的超敏感性，而不是由于交感神经过度活跃。(5)激光照射星状神经节，观察低反应强度激光对星状神经节的影响。(6)细胞因子为了研究脾脏在手术应激中的作用，我们研究了脾静脉血和动脉血中血浆细胞因子水平的变化。结果提示，脾在手术应激时产生大量IL-6。

项目成果

全泰律: "The Effet of the Partial Pressure of Oxygen on Blood Glucose Cohcentratlon Examimed Using Glucos Oyydase" Anesthesia & Analgesia. 79. 993-997 (1994)

Zentairi：“使用 Glucos Oyydase 检查氧分压对血糖浓度的影响”麻醉与镇痛 79. 993-997 (1994)。

中川博美: "Study of the stress Yespohse to acute pain in the awake human" The Paln Chmic. 7. 317-324 (1994)

Hiromi Nakakawa：“对清醒人类急性疼痛的应激研究”Paln Chmic，7. 317-324 (1994)。

Misako OMORI: "A Method for Evaluation of Sympathetic Activity using Spectral Analysis of Digital Blood Flow Wave" The Pain Clinic. 8(4). 227-233 (1995)

Misako OMORI：“使用数字血流波频谱分析评估交感神经活动的方法”疼痛诊所。

Akihiro FUJIWARA: "A Hypothesis on the Pathogenesis of Reflex Sympathetic Dystrophy ; Changes in Cutaneous Blood Flow and Plasma Catecholamine Concentration after Intravenous Regional Sympathetic Blockade with Guanethidine" The Pain Clinic. 9(1) (in press

Akihiro FUJIWARA：“反射性交感神经营养不良发病机制的假设；用胍乙啶静脉注射局部交感神经阻滞后皮肤血流和血浆儿茶酚胺浓度的变化”疼痛诊所。

藤原 昭宏: "A Hypothesis on the Pathogenesis of Reflex Spapothetic Dystrophy:Charges in Cutaneous Blood Flow and Plasma Catacholamire Comcentiation after intravenons Regional Syinpathetic Blockade with Granethi clinc" The Pain Clinic. 9. in press (1996)

Akihiro Fujiwara：“反射性肩胛骨营养不良发病机制的假设：Granethi 诊所静脉注射区域交感神经阻断后皮肤血流和血浆 Catacholamire 浓度的变化”《疼痛诊所》9. 出版（1996 年）。