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Potential application of 3-D computed topography and ion beam for a super-accurate nerve block.

3D 计算机地形图和离子束在超精确神经阻滞中的潜在应用。

基本信息

批准号：
23659315
负责人：
SAITO Shigeru
金额：
$ 2.5万
依托单位：
Gunma University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Challenging Exploratory Research
财政年份：
2011
资助国家：
日本
起止时间：
2011 至 2012
项目状态：
已结题

项目摘要

Potential use of 3-D computed topography and ion beam was assessed for a super accurate nerve block. Also, effects of nerve blocks and anesthetics on nerve activities were examined focusing on inhibitory neurotransmitters, such as GABA and glycine. Electrophysiological studies and behavioral experiments were adopted on gene manipulation rats. Descending inhibitory pathway and spinal cord glia were considered to play a crucial role in the chronic pain model.Slowly releasing drug delivery system, a poly-lactic acid and lidocaine conjugate was invented in this study, and the application for nerve blocks was assessed in rat model. Adverse effects on nerve fibers was examined histologically and behaviologically. Clinical study was also conducted in computer topography guided lumber sympathectomy. The topographic relationship between major vessels and the sympathectomy target was not identical across patients. We analyzed the shortest distances between the sympathectomy target and the major vessels, and the relationship between the location of the major vessels and the vertebral anterior line using CT images obtained during the procedure. At the L3 level, the shortest distances from the right side target to the inferior vena cava were significantly shorter than the other distances (P<0.05). In 11 of 36 patients (30.6%), the IVC was located dorsal tothe vertebral anterior line at the L3 level. Needle insertion for right sidesympathectomy at the L3 level may present a higher risk of major vessel puncture than sympathectomy at other sites. CT guidance is recommended for lumbar sympathectomy to reduce the risk of vascular puncture.

评估了三维计算机地形图和离子束用于超精确神经阻滞的可能性。此外，神经阻滞和麻醉剂对神经活动的影响进行了检查，重点是抑制性神经递质，如GABA和甘氨酸。对基因操作大鼠进行了电生理学和行为学研究。下行抑制通路和脊髓胶质细胞在慢性疼痛模型中起着重要作用，本研究设计了一种聚乳酸-利多卡因复合物缓释给药系统，并在大鼠模型中进行了神经阻滞的应用研究。对神经纤维的不良反应进行了组织学和行为学检查。并进行了计算机地形图引导下腰交感神经节切除术的临床研究。患者之间的主要血管和交感神经切除术目标之间的地形关系并不相同。我们分析了交感神经切除术目标和主要血管之间的最短距离，以及主要血管的位置和椎体前缘之间的关系，使用过程中获得的CT图像。在L3节段，右侧靶点至下腔静脉的最短距离明显短于其他节段（P<0.05）。IVC位于L3椎体前缘背侧者11例（30.6%）。在L3节段插入针行右侧交感神经切除术可能比其他部位的交感神经切除术存在更高的主要血管穿刺风险。建议在CT引导下进行腰交感神经切除术，以降低血管穿刺的风险。