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The Effects of Anesthetics and Transcutanclus Electrical Acupoint Stimulation on Skin Dynorphin and Kappa Receptor Expression

Author: JiaBin
Tutor: ZhaoWeiXian
School: Guangzhou University of Traditional Chinese Medicine
Course: Anesthesiology
Keywords: Narcotic drugs TEAS Skin Dynorphin k receptor
CLC: R969
Type: Master's thesis
Year: 2011
Downloads: 17
Quote: 0
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Abstract


The aim of the present study was to set different anesthesia program, observe the deadline for breast cancer patients undergoing surgery during the different anesthetic drugs and transcutaneous electrical stimulation (Transcutaneous Electrical Acupoint Stimulation, TEAS) on the skin of patients with the edge of the incision dynorphin (dynorphin) and k receptors (KOR) expression changes in order to deepen the understanding of the mechanism of action of the opioid system peripheral. Methods deadline unilateral modified radical mastectomy women met the inclusion criteria 80 patients. The anesthesia Select laryngeal mask general anesthesia. According to the random number table, the patients were randomly divided into four groups (n = 20 patients). Group 1: propofol fentanyl group; Group 2: propofol ketamine group; Group 3: propofol sevoflurane group; Group 4: propofol sevoflurane the TEAS surgery contralateral Neiguan Hoku , bilateral Taichong Point the Sanyinjiao group. All patients underwent preoperative conventional intramuscular luminal 0.1g, atropine 0.5mg. Blood pressure, SpO2, ECG, BIS monitoring into the operating room after the first connection. For Group 4, LH402 Korean electrical acupoint stimulation instrument, connecting the electric needle to the selected acupuncture points, waveform selection density wave (2/100HZ) stimulation 30min underwent general anesthesia, TEAS continue until the end of surgery. Induction, four groups herein are intravenous bolus of propofol the phenol loading dose (2mg/kg). Group 1 I fentanyl (3μg/kg); group 2 I ketamine (1mg/kg). The four groups were assisted ventilation mask hand control 3 minutes after placement laryngeal mask. Group 3, Group 4 sevoflurane inhalation. Anesthesia was maintained BIS values ??(50 ± 5), the skin incision and surgical stimulation without movement in response to standard dose adjustment. Each group to shun acid axillary atracurium (0.15mg/kg). Group 3, Group 4 stop at skin closure sevoflurane inhalation surgery, disable propofol. Recorded surgical time, anesthetic total intraoperative infusion total urine volume, the amount of bleeding before anesthesia (T1), after induction and intubation (T2), after incision (T3), after incision 15min (T4) After incision, after incision 30min (T5), 45min (T6), after incision 60min (T7), surgery (T8) eight time points in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and pulse oximetry (Sp02) and BIS values. Each group selected 10 cases, respectively, at the start of surgery and surgery 0.5cm × 2cm of skin tissue from each, the first paraffin embedded sections underwent strong FQ / KOR immunohistochemistry, analytical measurement sections positive protein optical density value. Data collection, collation observation table, create a database. Statistical analysis was performed using SPSS 13.0 statistical software, and the resulting data are expressed as mean ± standard deviation (summer ± s). P lt; 0.05 was considered statistically significant. Results 1. Were SBP, DBP, and MAP and Sp02 group comparison showed no statistical significance (PD gt; 0.05). Four groups of cases intraoperative BIS values ??in T1-T7 point in time, group 2 BIS values ??were higher than the other three groups, the difference was statistically significant (P lt; 0.05). Skin biopsy dynorphin peptide / KOR immunohistochemistry-positive protein mainly located in the basal layer of the epidermis and the spinous layer and basal cell and prickle cell cytoplasm. The same point in time in the four groups KOR optical density value of the skin tissue contrast the difference was not statistically significant (p gt; 0.05). Surgery before and after comparison group, the beginning of the operation, located on the edge of the skin of the incision immunohistochemistry slice can be observed in the basal layer of the epidermis and the spinous layer and basal cell and prickle cell cytoplasm trace KOR expression. The end of surgery, the immunohistochemistry slice of the cut edge of the skin, the increase in the basal layer of the epidermis and the stratum spinosum and basal cell and prickle cell cytoplasm KOR expression of the difference was statistically significant (p lt; 0.01). Conclusion injury inflammation, the edge of the surgical incision within the skin dynorphin and KOR appear at the end of surgery increased expression; different anesthetic medication and TEAS impact of increased skin tissue levels of dynorphin and KOR surgery is no different; skin injury site dynorphin and KOR increase may be mainly related with the inflammation of the injury, narcotic drugs and TEAS its impact may not be significant.

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