| Objective: To investigate the usability of the compound lidocaine hydrochloride injection in superior cervical ganglion block(SCGB). Superior cervical ganglion block can treat many clinical disease effectly, not only for cervical and upper thoracic region disease, but also can modulate the functions of nerve, endocrine and immune system. So it is very widly used in pain clinical treatments especialy stellate ganglion block(SGB). Now local anesthetics are widely used in SCGB, such as lidocaine, bupivacaine and ropivacaine. But the longest last effective time is not more than 12 hours. So SCGB is operated one time every day or two days, and 10-15 times every treatment, but almost c- hronic disease need 2-3 treatments. In addition, there are alwa- ys some dangerous during SCGB because of the especial stell- ate ganglion anatomy, sometimes is fatal. Compound Lidocaine Hydrochloride Injection contains Lidocaine Hydrochloride (0.8%), mentol (0.13%), a little of glycerin and alcohol. The eff- ective time is about 48 hours to 240 hours. If Compound Lid- ocaine Hydrochloride Injection can be used in SCGB, there will be not only longer time effect, less complication, but also can d- ecrease the spends. But there are no reports about the effect of Compound Lidocaine Hydrochloride Injection on sympathetic ganglion neurons. The purpose of this research was to study if Compound Lidocaine Hydrochloride Injection can be used in SCGB.Cervical sympathetic ganglion is composed of the superior cervical ganglion, the middle cervical ganglion and the inferior cervical ganglion. And the histology and function of the three cervical sympathetic ganglions are the same ,but superior cerv- ical ganglion is the easiest and safest to be explored. The super- ior ganglion was chosed for this study.Methods: The experiments were performed on 72 adult rabbits either sex. These animals were divided into two groups randomly of each 36, including Group L and Group K. Then ea- ch group was divided into two subgroups: Group L1 n=12, Gro- up K1 n=12, Group L2 n=24 and Group K2 n=24. All rabbits were anaesthetized by injecting katamine. Under the condition of asepsis, the tissue of rabbits was cut open to expose the left superior cervical ganglion, injected 0.4 ml 2% lidocaine in gro- up L and 0.4 ml Compound Lidocaine Hydrochloride Injection in group K; then closing up. At before injection and the 2 hour, the 1 week, 2 week after injection, each 6 rabbits were anaesth- etized and their left superior ganglions were taken out. Half of them were observed HE staining, and Toluidine blue staining. The others were observed ultrastructrure under EM. The temp- erature of the left ear root and the Horner's syndrome were reco- rded at before operation, and 5 min, 30min, 1 week, 2 week aft- er injection. The temperature of the lab was controlled about 24 degree.Results : All the animals recovered from the general anes- thesia within 3 min. Ipsilateral eyelid droop (ptosis) was obser- ved in group L and group K. The duration and extent of ptosis of each group is shown in table 1. The extent of ptosis droop of gr- oup L1 is more serious and sooner than group K1 (P<0.05). But the lasting time is shorter.There was no statistically significant change in temperature between group L1 and group K1 (P>0.05). At 5 min and 30 min the temperature of both group were higher than before (p<0.01), but at 1 week and 2 week there was no significant different in group L1 with before (p>0.05). At 1 week the temperature was still higher than before in group K1 (P<0.05). And there was no significant different change at 2 week with before and with group L1 at 2 week.Content of Nissl bodies was not statistically significant ch- ange between group L2and group K2(P>0.05). Content of Nissl bodies was significant less at 2 hour than any other time in both group L2 and group K2, but there was statistically change bet- ween them(p<0.05). At the 1 and 2 week there was no statis- tically change in content of nissl bodies in group L2. But the co- ntent was still less than before injection at the 1 week in group K2 . There was no significant change among two groups at the 2 week. They were all recovered.Under EM, before injection they were all normal. In group L2 there were serious edema at 2 hour but then recovered foll- owing. In group K2, at 2 hour, there were serious edema, Nissl body decreased, part or most part of membrane of mitochondria interfused or disappeared, some of mitochondria was bubbly or pulpation. At 1 week ultrustructure still had some damaged, but went better than 2 hour. At 2 week there were normal Golgi apparatus and rough endoplasmic and mitochondria.Conclusion: The compound lidocaine hydrochloride inje- ction is a good lente anesthetic, last for about 10 days and can recover. The compound lidocaine hydrochloride injection can be used in superior ganglion block safely.
|
PDF Full Text Request