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

评估了三维计算机地形和离子束在超精确神经阻滞中的潜在应用。此外，神经阻滞和麻醉剂对神经活动的影响主要集中在抑制性神经递质，如GABA和甘氨酸。对基因操作大鼠进行电生理研究和行为实验。下行抑制通路和脊髓胶质细胞被认为在慢性疼痛模型中起关键作用。本研究发明了一种聚乳酸-利多卡因缀合物缓释给药系统，并在大鼠神经阻滞模型中评估其应用。对神经纤维的不良反应进行组织学和行为学检查。计算机地形图引导下的腰椎交感神经切除术也进行了临床研究。主要血管与交感神经切除目标之间的地形关系在不同患者中并不相同。我们利用手术过程中获得的CT图像分析了交感神经切除目标与大血管之间的最短距离，以及大血管位置与椎体前线之间的关系。在L3水平，右侧靶到下腔静脉的最短距离明显短于其他距离（P<0.05）。在36例患者中，11例（30.6%）的下腔静脉位于椎体前部L3水平的背侧。与其他部位的交感神经切除术相比，在L3水平的右侧交感神经切除术中插入针可能会有更高的大血管穿刺风险。腰椎交感神经切除术推荐CT引导，以减少血管穿刺的风险。

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.