Analysis of Immunological Changes during Anesthesia and Surgery

(1)术中应激和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或NLA麻醉的大手术期间免疫抑制的变化。(2)术中应激与血浆皮质醇浓度硬膜外阻滞全麻对上腹部手术期间血浆皮质醇浓度的升高无抑制作用。内脏神经阻滞明显抑制血浆皮质醇浓度的升高。(3)聚集。然而，围术期应激可能对血小板聚集有相对影响，目前尚无确切的方法来评价血小板功能。结论：新的血小板聚集试验是必要的。(4)交感神经系统具有将应激(包括疼痛应激)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中交感神经系统对疼痛刺激的反应。(5)对20例RSD患者进行了反射性交感神经营养不良(RSD)的评估，RSD是我们临床上用于止痛的新方法。我们展示了新的方法是如何评估RSD患者的疼痛的，通过监测皮肤血流的变化进行定量分析。(6)星状神经节阻滞(SGB)星状神经节分布于上肢、面部和头部。观察SGB对周围血液循环的影响。

(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.