Zittel T T, Meile T, Jehle E C, Becker H D
Department of General and Transplantation Surgery, University Hospital, Tübingen, Germany.
Langenbecks Arch Surg. 2001 Apr;386(3):204-11. doi: 10.1007/s004230100228.
Postoperative gastric ileus interferes with postoperative recovery of the patients. Previous studies suggest that capsaicin-sensitive afferent neurons are involved in the mediation of postoperative gastric ileus.
A group of rats were equipped with a strain gauge transducer sutured to the gastric wall. Gastric motility was recorded after intraperitoneal injection of capsaicin (0.1 micromol/kg and 1 micromol/kg) or vehicle. The rats were given 2 days of recovery before gastric motility was investigated in a postoperative ileus model.
Pretreatment with capsaicin 2 days prior to abdominal surgery significantly increased postoperative gastric motility, with complete recovery of gastric motility at 30 min postoperatively (with the baseline motility index set at 100+/-4%, the gastric motility index 30-45 min postoperatively was 64+/-4% for the vehicle, 138+/-20% for capsaicin 0.1 micromol/kg, and 110+/-12% for capsaicin 1 micromol/kg: P=0.0008 vehicle vs capsaicin). In contrast, capsaicin treatment 2 h prior to abdominal surgery did not increase postoperative gastric motility (gastric motility index 30-45 min postoperatively was 64+/-4% for the vehicle and 51+/-8% for capsaicin 0.1 micromol/kg). The acute intraperitoneal injection of capsaicin decreased gastric motility by about 50-60%, the response lasting for 15-30 min.
Intraperitoneal capsaicin treatment 2 days prior to abdominal surgery resulted in immediate recovery of postoperative gastric motility, indicating an important role for serosal visceral afferent nerve fibers in the mediation of postoperative gastric ileus. Possibly, capsaicin or vanilloid (capsaicin) receptor agonists can be used to treat postoperative ileus in the future.
术后胃麻痹会干扰患者的术后恢复。先前的研究表明,辣椒素敏感传入神经元参与了术后胃麻痹的调节。
一组大鼠被安装了缝合在胃壁上的应变片传感器。腹腔注射辣椒素(0.1微摩尔/千克和1微摩尔/千克)或溶剂后记录胃动力。在术后肠梗阻模型中研究胃动力之前,让大鼠恢复2天。
腹部手术前2天用辣椒素预处理可显著增加术后胃动力,术后30分钟胃动力完全恢复(将基线动力指数设定为100±4%,术后30 - 45分钟溶剂组的胃动力指数为64±4%,0.1微摩尔/千克辣椒素组为138±20%,1微摩尔/千克辣椒素组为110±12%:溶剂组与辣椒素组比较,P = 0.0008)。相比之下,腹部手术前2小时用辣椒素处理并未增加术后胃动力(术后30 - 45分钟溶剂组的胃动力指数为64±4%,0.1微摩尔/千克辣椒素组为51±8%)。腹腔急性注射辣椒素可使胃动力降低约50 - 60%,该反应持续15 - 30分钟。
腹部手术前2天腹腔注射辣椒素可使术后胃动力立即恢复,表明浆膜内脏传入神经纤维在术后胃麻痹的调节中起重要作用。将来,辣椒素或香草酸(辣椒素)受体激动剂可能可用于治疗术后肠梗阻。