左T7准脊椎神经阻塞激活α7nAChR-依赖的CAP在经过胸腔镜叶切除术的患者中:一项前性受控研究
Fang Xingjun1,2, Zhang Ruijiao1, Yuan Peihua1
1Department of Anesthesiology and Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330001, China.
BMC anesthesiology
|December 25, 2024
概括
左T7胸前副脊椎神经阻塞 (TPVB) 激活了胆固醇抗炎途径. 这种方法通过调节α7nAChR水平,有效降低胸腔镜叶切除术后的术后炎症.
科学领域:
- 麻醉学 麻醉学
- 外科手术炎症 在外科手术炎症.
- 神经免疫学 神经免疫学
背景情况:
- 胸腔镜叶切除术可以引发显著的炎症反应.
- 由α7nAChR介导的胆性抗炎途径在调节炎症方面发挥着至关重要的作用.
- 了解区域麻醉如何影响这种途径对于优化术后恢复至关重要.
研究的目的:
- 为了研究左T7胸前副脊椎神经阻塞 (TPVB) 对α7nAChR依赖的胆固醇抗炎途径的影响.
- 评估LTPVB对外科手术期间炎症标志物和脏动脉阻抗指数 (RI) 的影响.
主要方法:
- 一项比较性研究涉及接受胸腔镜叶切除术的患者,分为左T7 (LTPVB) 和右T7 (RTPVB) 阻塞组.
- 使用多普勒超声波在阻塞前后测量脏动脉RI.
- 术前α7nAChR水平和炎症因子 (IL-1β,IL-6,TNF-α) 的量化.
主要成果:
- 左T7 TPVB显著降低了脏动脉RI.
- 两组都显示了手术后α7nAChR水平的增加,但在12小时和24小时的LTPVB组显着更高.
- 在手术后,炎症标志物 (IL-1β,IL-6,TNF-α) 在LTPVB组明显低于RTPVB组.
结论:
- 在左T7水平的TPVB有效地激活了α7nAChR依赖的胆固醇抗炎途径.
- 左T7TPVB证明了在胸腔镜叶切除术后缓解术后炎症反应的潜力.
- 这表明通过区域麻醉来管理手术炎症的有针对性的方法.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
551
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
551
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
350
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
350
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
317
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
317
Skeletal Muscle Relaxants: Therapeutic Uses
438
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
438
Local Anesthetics: Differential Sensitivity of Nerve Fibers
726
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
726
Depolarizing Blockers: Mechanism of Action
1.1K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
1.1K


