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

3D 计算机地形图和离子束在超精确神经阻滞中的潜在应用。

基本信息

批准号：
23659315
负责人：
SAITO Shigeru
金额：
$ 2.5万
依托单位：
Gunma University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Challenging Exploratory Research
财政年份：
2011
资助国家：
日本
起止时间：
2011 至 2012
项目状态：
已结题

项目摘要

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.

评估了 3D 计算机地形图和离子束用于超精确神经阻滞的潜在用途。此外，还检查了神经阻滞和麻醉剂对神经活动的影响，重点关注抑制性神经递质，例如 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发挥着至关重要的作用。本研究发明了聚乳酸和利多卡因缀合物缓释药物递送系统，并在大鼠中评估了神经阻滞的应用模型。从组织学和行为学角度检查对神经纤维的不利影响。还进行了计算机地形图引导腰交感神经切除术的临床研究。不同患者的主要血管和交感神经切除目标之间的地形关系并不相同。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主要血管之间的最短距离，以及主要血管位置与椎体前线之间的关系。在L3水平，右侧目标到下腔静脉的最短距离显着短于其他距离（P<0.05）。 36 名患者中有 11 名 (30.6%) 的 IVC 位于 L3 水平椎体前线的背侧。与其他部位的交感神经切除术相比，在 L3 水平进行右侧交感神经切除术的进针可能会导致大血管穿刺的风险更高。建议在CT引导下进行腰交感神经切除术，以降低血管穿刺的风险。