| To investigate a series of effects of preoperative stellate ganglion block(SGB)on gastrointestinal function in rats undergoing gastrointestinal and non-gastrointestinal abdominal surgery and assess the possible mechanism, providing an effective theoretical basis for the prevention of gastrointestinal dysfunction after abdominal operations.Fifty four male Sprague-Dawley rats, weighing(200±10)g, were randomly divided into 5 groups: control group(n=6, group C), gastrointesinal abdominal surgery group(n=12,group A), SGB+ gastrointesinal abdominal surgery group(n=12,group SA), non-gastrointestinal abdominal surgery group(n=12,group B), SGB+non-gastrointestinal abdominal surgery group(n=12, group SB). Group SA and Group SB cervical ganglion were exposed and splited, then blocked with 0.25% bupivicaine 0.15ml;Group A and Group B cervical ganglion were exposed and splited, then inject normal saline 0.15 ml, 15 minutes later, Group SA and Group A colon were cutted at 2cm to ileocecal colon and given a end-to-end intestinal anastomosis to establish gastrointesinal abdominal surgery model,but non-gastrointestinal abdominal surgery model were established by exploratory laparotomy in Group SB and Group B. Group C were given no action.Blood collection to test serum NE, TNF-α and IL-6 at the time before stellate ganglion block(T1), at the end of operation(T2), and at12 h and 24 h after operation(T3-T4); Six rats were randomly chosen from each group to test bowel propulsion rate at 12 h and 24 h after operation( T3-T4), then sacrificed to measure MTL and VIP in antrum and proximal colon. Gastrointestinal tissue were kept for histologicalexamination by HE staining with light microscopy.The results show that:1. Compared with T1, the serum NE concentration significantly increased at T2-T4 in group A、 SA、 B and SB(P<0.05)which both peaked at T2, and both significantly higher than group C( P<0.05).Compared with group SA, the serum NE levels were significantly increased in group A(P<0.05), Compared with group SB, the serum NE levels were significantly increased in group B(P<0.05).2. Compared with T1,the serum TNF-α concentration significantly increased at T2-T4 in group A、SA、B and SB(P<0.05)which both peaked at T2, and both significantly higher than group C(P<0.05). Compared with group SA,the serum TNF-α levels were significantly increased in group A( P<0.05), Compared with group SB, the serum NE levels were significantly increased in group B(P<0.05).3. Compared with T1, the serum IL-6 concentration significantly increased at T2-T4 in group A 、 SA、 B and SB( P<0.05), and both significantly higher than group C(P<0.05). Compared with group SA,the serum IL-6 levels were significantly increased in group A( P<0.05),Compared with group SB, the serum NE levels were significantly increased in group B(P<0.05).4. Compared with 12 h, the bowel propulsion rate significantly increased at 24 h in group A、SA、B and SB(P<0.05), and both significantly less than group C(P<0.05).Compared with group A, the bowel propulsion rate was significantly increased in group SA(P<0.05), Compared with group B, the bowel propulsion rate was significantly increased in group SB(P<0.05).5. The MTL levels at 24 h were significantly higher than at 12 h in group A、 SA、 B and SB(P<0.05), and both significantly lower than group C(P<0.05). The MTL levels in group SA were significantly higher than in group A(P<0.05), The VIP levels in group SB were significantlyhigher than in group B(P<0.05).6. The VIP levels at 24 h were significantly lower than at 12 h in group A、 SA、 B and SB(P<0.05), and both significantly higher than group C(P<0.05). The VIP levels in group SA were significantly lower than in group A(P<0.05), The VIP levels in group SB were significantly lower than in group B(P<0.05).7. In histopathology observation, the gastric antrum in five groups of rats were normal, no signs of inflammation and edema, colon tissue in group C 、B、SB were normal, non-inflammatory edema. Inflammation and edema in colon tissue of group A is the most serious, infiltrated with a large number of acute and chronic inflammatory cells, and Inflammation and edema in colon tissue of Group SA is milder than in group A.From results, the following conclusions can be drawn:1.Preoperative stellate ganglion block can effectively reduce the stress response in patients undergoing abdominal surgery.2.As the stress response of the abdominal surgery, the inflammatory reaction is induced, and inflammatory cytokine has incressed. SGB can effectively reduce the inflammatory reaction by lowering the concentrations of inflammatory cytokine.3.Gastrointestinal and non-gastrointestinal abdominal surgery can cause gastrointestinal dysfunction. Preoperative stellate ganglion block can promote the restoration of gastrointestinal function after gastrointestinal and non-gastrointestinal abdominal surgery.4. Preoperative stellate ganglion block can reduce the stress response and inflammatory reaction, regulate gastrointestinal hormone, which may be of some protection for gastrointestinal function. |
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