神经刺激器不同强度电流对兔坐骨神经阻滞的影响  

THE EFFECT OF PERIPHERAL NERVE STIMULATOR WITH DIFFERENT CURRENT STRENGTHS ON THE SCIATIC NERVE BLOCK IN RABBITS

作　　者：邹江[1] 张兆晖[1] 魏湘华[1] 唐育民[1] 

机构地区：[1]四川省肿瘤医院麻醉科,成都610041

出　　处：《现代预防医学》2008年第21期4276-4277,共2页Modern Preventive Medicine

摘　　要：[目的]使用神经定位刺激器进行兔坐骨神经阻滞,比较不同强度电流对阻滞效果及神经细胞的影响。[方法]日本大耳白家兔25只,耳缘静脉2.5%硫喷妥钠持续滴注镇静,随机行双下肢坐骨神经阻滞。使用神经刺激器一侧为A组,不使用神经刺激器一侧为B组。其中A组根据刺激电流0.5、1、2、3、4mA分为5个亚组。两组穿刺部位及用药均相同。观察阻滞起效时间、阻滞维持时间及双侧坐骨神经受刺激处细胞的病理生理变化。[结果]①A组5个亚组阻滞起效时间分别为(2.33±0.18)min,(2.22±0.20)min,(2.17±0.09)min,(2.24±0.17)min,(2.39±0.11)min;B组阻滞起效时间分别为(2.27±0.26)min,(2.42±0.17)min,(2.45±0.15)min,(2.39±0.11)min,(2.47±0.18)min。②A组5个亚组阻滞持续时间分别为(33.24±3.22)min,(35.35±2.49)min,(32.23±3.24)min,(35.38±3.19)min,(34.38±3.13)min;B组阻滞持续的时间分别为(27.16±3.15)min,(28.17±2.55)min,(29.25±2.44)min,(28.32±2.39)min,(28.29±3.18)min(与A组比较P﹤0.05)。③镜下观察A组0.5、1、2mA亚组及B组神经细胞形态基本正常,细胞核大小一致、变异较少。A组3、4mA亚组神经细胞混浊肿胀明显,较多空泡化;细胞核异型性大,核染色质深。明显异常于B组。[结论]神经刺激器定位神经阻滞技术起效快,麻醉维持理想,但应避免长时间大电流刺激。[Objective] Using the nerve stimulator to compare the effect of peripheral nerve stimulating with different current strengths on peripheral nerve block and the consequence in the nerve ceils. [Methods] Twenty-five Japanese long-ear white rabbits of beth sexes were anesthetized with 2.5% thiopental and blocked the sciatic nerve. The rabbits were divided into group A and group B which were with or without nerve stimulating. According＇ to the strength of current, the group A were divided into 5 sub-groups with 0.5mA, 1.0mA, 2mA, 3mA and 4mA stimulating currents respectively. The group A and B had the same injecting point and drug administration. The onset time, the duration of blockage and the pathophysiologic change of bilat- eral sciatic nerve ceils at the stimulated points were inv.estigated. [Results] ① The stimulating onset ume were （2.33±0.181） min, （2.22±0.20） min, （2.17±0.09） rain, （2.24±0.17） rain, and （2.39±0.11） min respectively in the group A 5 subgroups, and （2.38±0.14） rain in group B. ② The duration of blockage were （33.24±3.22） min, （35.35±2.49） rain, （32.23±3.24） min, （35.39±3.19） nfin, and （34.38±3.13） rain respectively in group A 5 sub-groups, and （28.26-＋3.32） min in group B （P 〈 0.05）. ③ The conformation of the nen＇e cells were normal basically, and the size of the nucleus were constant with httle variation in group A with 0.5mA, 1mA, and 2mA stimulating current sub-groups and group B under microscope. The nerve ceils were swollen and opaque with many vacuoles, and had heteromorpheous nucleus and stained chromatin in group A 3mA and 4mA sub-groups, which were different with group B obviously. [ Conclusion ] Nerve stimulator used for leading the locating of local anesthetics injection has the advantage of fast acting and ideal maintain, but the long time and large current stimulating should be avoided.

关 键 词：神经刺激器 电流 坐骨神经 

分 类 号：R74[医药卫生—神经病学与精神病学]