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期间吸入麻醉组和NLA麻醉组均出现免疫抑制改变。硬膜外阻滞或内脏神经阻滞全麻可抑制上述变化。(2)术中应激与血浆皮质醇浓度硬膜外阻滞全麻不能抑制上腹部手术时血浆皮质醇浓度的升高。交感神经系统：包括手术应激和疼痛应激在内的几种应激对交感神经系统的影响。通过监测血流量和出汗的变化，可以对疼痛进行量化分析。(4)反射性交感神经营养不良(RSD)我们的数据表明，难治性RSD的自主神经功能障碍是由于对交感神经递质的过度敏感，而不是交感神经过度活动。(5)激光照射星状神经节，我们评估了低反应激光的效果。(6)细胞因子为了研究脾在手术应激下的作用，我们观察了脾静脉血和动脉血中细胞因子水平的变化。结果提示，在手术应激条件下，脾组织产生大量的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.