Iwase Yoshinori, Shimada Steven G, Sekiyama Hiroshi, Yamauchi Masanori, Collins J G
Second Department of Anesthesiology, Dokkyo University School of Medicine, Tochigi 321-0293.
Masui. 2002 Apr;51(4):360-8.
We report here an efficient means of epidural catheter placement through atlanto-occipital membrane in rats.
Male SD rats (n = 84) were divided into lumbar (n = 48) and cervical (n = 36) groups. Under sterile technique, PVC V-1 tubing was inserted and advanced caudally targeted to the C 4 or L 4 level. Analgesic efficacy and duration were measured by injecting increments of 2% lidocaine until a maximum paw withdrawal latency time from a radiant heat thermal stimulator. Rats (n = 6 each day) were sacrificed and an autopsy was performed to observe both the laterality of the catheter tip and the proliferation of fibrous tissue around the catheter.
The volume of lidocaine and its duration was 52 +/- 17 microliters and 27 +/- 13 min (mean +/- SD) in lumbar, 30 +/- 10 microliters and 26 +/- 9 min in cervical group. In lumbar group, two catheters penetrated the dura. The remaining catheters were confirmed to be in the epidural space within L 4 +/- 1 or C 4 +/- 2 segment. Lumbar catheter tips were almost equally distributed between the center, left and right, while cervical catheter tips were distributed between left and center portion of the epidural space. The severity of tissue proliferation was time dependent. The proliferation of fibrotic tissue seemed more rapid in cervical than lumbar group.
Although this approach for epidural catheter placement is efficient and produces excellent drug effects on day 3 after implantation, as reported by others, rapid development of fibrous tissue around the catheter quickly limits the usefulness of the epidural catheter.
我们在此报告一种通过大鼠寰枕膜进行硬膜外导管置入的有效方法。
雄性SD大鼠（n = 84）分为腰椎组（n = 48）和颈椎组（n = 36）。在无菌技术下，插入PVC V - 1导管并向尾端推进，目标是C4或L4水平。通过注射递增剂量的2%利多卡因直至从辐射热刺激器获得最大爪退缩潜伏期时间来测量镇痛效果和持续时间。每天处死6只大鼠并进行尸检，以观察导管尖端的位置及导管周围纤维组织的增生情况。
腰椎组利多卡因的用量及其持续时间分别为52±17微升和27±13分钟（平均值±标准差），颈椎组为30±10微升和26±9分钟。在腰椎组，两根导管穿透了硬脊膜。其余导管被证实位于L4±1或C4±2节段的硬膜外间隙内。腰椎导管尖端在中央、左侧和右侧的分布几乎相等，而颈椎导管尖端分布在硬膜外间隙的左侧和中央部分。组织增生的严重程度与时间有关。颈椎组纤维组织的增生似乎比腰椎组更快。
尽管如其他人所报道的，这种硬膜外导管置入方法是有效的，并且在植入后第3天产生了良好的药物效果，但导管周围纤维组织的快速生长迅速限制了硬膜外导管的实用性。
