硬脊膜外腔阻滞对兔神经根病理学影响的实验研究

AN EXPERIMENTAL INVESTIGATION OF THE EFFECT OF EPIDURAL ANESTHESIA ON RADICULOPATHOLOGY IN RABBIT

目的 :通过观察脊髓、神经根的超微结构变化 ,了解利多卡因、罗哌卡因注入硬膜外腔后对已损伤神经根的组织病理学影响。方法 :实验用大白兔 30只 ,硬膜外腔置管成功后随机分 5组 ,每组6只。L组 :注入利多卡因。R组 :注入罗哌卡因。S组 :在置管同一间隙损伤一侧神经根。SL组 :损伤一侧神经根后注入利多卡因。SR组 :损伤一侧神经根后注入罗哌卡因。除S组外 ,余均每隔12小时注药一次 ,连续 2日 ,第七日灌杀、固定、取材 ,进行光镜电镜观察。结果 :SL组、SR组有明显的细胞器变性及神经根脱髓鞘等改变。结论 :临床操作出现神经根损伤时 ,应慎用椎管内阻滞。

Objective: To investigate the pathologic influence of epidural anesthesia on nerve root when it was injured. Methods: Thirty rabbits with segmental epidural catheter were randomly divided into five groups: group L(n=6),group R(n=6),group S(n=6),group SL(n=6),and group SR(n=6). Lidocaine and Ropivacaine were injected respectively into epidural space in group L and group R. A lateral nerve root was artificially injuried at the same interspace where the epidural catheter was placed in group S. Lidocaine and Ropivacaine were injected respectively into epidural space in group SL and group SR after a lateral nerve root was artificially injuried as group S.The local anesthetics were injected every 12 hours at every group except group S,and continued two day.After seven days rabbits were put to death for advanced investigation. Results:There are obvious degeneration of the organelles and demyelination of nerve roots in group SL and group SR. Conclusions: Intrathecal block should be used cautiously when nerve root is injuried.