利多卡因注射大鼠背根神经节致神经炎症的研究  

作　　者：Livia Puliak Sanja Lovric Kojundzic Quinn H. Hogan Damir Sapunar 刘冲(译) 喻田(校) 

机构地区：[1]Department of Histology and Embryology, University of Split School of Medicine, Croatia [2]Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin [3]不详

出　　处：《麻醉与镇痛》2010年第6期93-98,共6页Anesthesia & Analgesia

摘　　要：背景选择性脊神经阻滞导致的脊神经或背根神经节（DRG）损伤是至今尚未充分研究的一种潜在的严重并发症。本实验假设局部麻醉药注入脊神经、DRG内可能会导致炎性反应与痛觉过敏。方法大鼠部分椎板切除后，于L5脊神经或背根神经节内注射4μl利多卡因或盐水，评价其炎性反应及行为反应。行为学测试在手术前、手术后分别进行，通过观察并记录大鼠对足部伤害性机械刺激的反应，并对痛觉过敏进行评估。摘取背根神经节并染色，对神经元周围起免疫反应的神经胶质细胞环进行计数。结果与脊神经利多卡因注射组相比，DRG利多卡因注射组注射利多卡因4天后出现了同侧足部的痛觉过敏。神经胶质原纤维酸性蛋白免疫阳性的神经胶质细胞环，即激活的卫星细胞的数量，在DRGs内的表达，DRG和脊神经利多卡因注射组均明显增加。同盐水注射组相比，利多卡因注射组神经胶质原纤维酸性蛋白阳性细胞明显增多，并在DRGs内发现了散在的、能代表激活的小神经胶质细胞的OX-42免疫阳性细胞。通过检测能标记激活的T淋巴细胞的Pan-T，并未发现T淋巴细胞。结论DRG内注射利多卡因可导致痛觉过敏，可能是通过激活固有的卫星神经胶质细胞。临床上，选择性脊神经阻滞时，应避免DRG内直接注射局部麻醉药。BACKGROUND： Injury of a spinal nerve or dorsal root ganglion （DRG） during selective spinal nerve blocks is a potentially serious complication that has not been adequately investigated. Our hypothesis was that local anesthetic iniection into these structures may result in an inflammatory response and hyperalgesia. METHODS： We evaluated inflammatory and behavioral responses after injection of 4 μl lidocaine or saline into the L5 spinal nerve or DRG of rats after partial laminectomy. Behavioral testing was performed before and after surgery to examine hyperalgesia in response to nociceptive mechanical stimulation of the foot. DRGs were harvested and stained, and rings of immtmoreactive glial cells around neurons were counted. RESULTS： Animals demonstrated hyperalgesia on the ipsilateral paw up to 4 days after lidocaine injection into the DRG but not after injection into the spinal nerve. The number of glial fibrillary acid protein immunopositive glial cell rings, which represent activation of satellite cells, significantly increased in DRGs after injection of lidocaine into either the DRG or the spinal nerve. The number of glial fibrillary acid protein-positive cells in the lldocaine-injected group was significandy larger than in the saline-injected group. Sporadic OX-42 immunopositive cells, which represent activated microglia, were also seen in lidocaine-injected DRGs. Testing for Pan-T expression, which labels activated T Iymphocytes, showed no positive cells. CONCLUSIONS： Lidocaine injection into the DRG may produce hyperalgesia, possibly due to activation of resident satellite glial cells. In a clinical setting, local anesthetic injection into the DRG should be avoided during selective spinal nerve blocks.

关 键 词：背根神经节 利多卡因 内注射 神经胶质原纤维酸性蛋白 神经炎症 大鼠 小神经胶质细胞 免疫阳性细胞 

分 类 号：R338[医药卫生—人体生理学]