兔乙醇胫神经干阻滞的量效关系研究

关键词：量效关系  神经溶解技术  酒精  胫神经  复合肌肉动作电位

Keywords:dose-response relationship  neurolysis  alcohol  tibial nerve  compound muscle action potential

摘要：

      摘要 目的：明确兔乙醇胫神经阻滞的量效关系。 方法：新西兰兔24只，胫神经44条，外周神经电刺激器引导下，行胫神经无水乙醇阻滞。按注射容量分为4组：0.1ml、0.3ml、0.5ml和1.0ml。分别于阻滞前和阻滞后第1、2、4、7天及2、3、4、5、6、7、8周，记录腓肠肌复合肌肉动作电位（CMAP)；实验终止时,取胫神经和注射部位肌肉行HE染色，观察组织学损害。 结果：小容量0.1ml组CMAP波幅在第1周有所恢复，但第2周作用基本消失(P＞0.05)，而0.3ml组的作用持续到第8周（P＜0.05）；大容量组（0.5ml和1.0ml）CMAP波幅降低更明显（P＜0.05），但并发症也显著增加。大部分动物（9/15）因并发症死亡，故实验在第4周终止。前4周CMAP波幅降低，除0.3ml与0.5ml组间差异不显著（P＞0.05），其他各组间差异显著（P＜0.05）；组织学示各组出现不同程度神经轴索变性；0.5ml和1.0ml组肌肉局灶性结缔组织增生。 结论：兔乙醇胫神经干阻滞的理想有效安全容量是0.3ml/点。

Abstract:

      Abstract Objective: To verify the dose-response relationship in alcohol-induced rabbits′ tibial nerve block. Method: Twenty-four New Zealand white rabbits were randomly assigned to four groups based on alcohol volume (0.1ml、0.3ml、0.5ml、1.0ml). All tibial nerves were successfully located with a nerve electrical stimulator. Compound muscle action potential (CMAP) was measured on the skin surface of gastrocnemius muscle belly preintervention and at days 1, 2, 4, 7 and weeks 2, 3, 4, 5, 6, 7, 8 postblock. Histologic studies were performed to evaluate the destruction of tibial nerves and muscles. Result: In four groups, CMAP amplitude showed reduction 1 day after nerve block. In group 0.1ml, CMAP amplitude showed the smallest reduction at 1 day and recovered in 1 week after block, but the block effect disappeared at 2 week after block(P>0.05). In group 0.3ml， the block effect last 8 weeks. In groups 0.5ml and 1.0ml, CMAP amplitudes showed maximal reduction 1 day after block 4 weeks and no increase later. There was no statistically difference between groups 0.3ml and 0.5ml (P<0.05). Axonal degeneration was evident within the tibial nerve among all groups. Muscle desmoplasia was noted within the groups of 0.5ml and 1.0ml. Conclusion: The most effective and safest volume is 0.3ml for alcohol induced rabbits′ tibial nerve block.