Bauck Anje G, Grosche Astrid, Morton Alison J, Graham A Sarah, Vickroy Thomas W, Freeman David E
Am J Vet Res. 2017 Aug;78(8):977-989. doi: 10.2460/ajvr.78.8.977.
OBJECTIVE To examine effects of continuous rate infusion of lidocaine on transmural neutrophil infiltration in equine intestine subjected to manipulation only and remote to ischemic intestine. ANIMALS 14 healthy horses. PROCEDURES Ventral midline celiotomy was performed (time 0). Mild ischemia was induced in segments of jejunum and large colon. A 1-m segment of jejunum was manipulated by massaging the jejunal wall 10 times. Horses received lidocaine (n = 7) or saline (0.9% NaCl) solution (7) throughout anesthesia. Biopsy specimens were collected and used to assess tissue injury, neutrophil influx, cyclooxygenase expression, and hypoxia-inducible factor 1α (HIF-1α) expression at 0, 1, and 4 hours after manipulation and ischemia. Transepithelial resistance (TER) and mannitol flux were measured by use of Ussing chambers. RESULTS Lidocaine did not consistently decrease neutrophil infiltration in ischemic, manipulated, or control tissues at 4 hours. Lidocaine significantly reduced circular muscle and overall scores for cyclooxygenase-2 expression in manipulated tissues. Manipulated tissues had significantly less HIF-1α expression at 4 hours than did control tissues. Mucosa from manipulated and control segments obtained at 4 hours had lower TER and greater mannitol flux than did control tissues at 0 hours. Lidocaine did not significantly decrease calprotectin expression. Severity of neutrophil infiltration was similar in control, ischemic, and manipulated tissues at 4 hours. CONCLUSIONS AND CLINICAL RELEVANCE Manipulated jejunum did not have a significantly greater increase in neutrophil infiltration, compared with 4-hour control (nonmanipulated) jejunum remote to sites of manipulation, ischemia, and reperfusion. Lidocaine did not consistently reduce neutrophil infiltration in jejunum.
目的 研究持续输注利多卡因对仅接受操作且远离缺血肠段的马肠道跨壁中性粒细胞浸润的影响。
动物 14 匹健康马。
方法 实施腹正中剖腹术(时间0)。在空肠和大结肠段诱导轻度缺血。通过按摩空肠壁10次对1米长的空肠段进行操作。在整个麻醉过程中,马接受利多卡因(n = 7)或生理盐水(0.9%氯化钠)溶液(7匹)。在操作和缺血后0、1和4小时收集活检标本,用于评估组织损伤、中性粒细胞流入、环氧化酶表达和缺氧诱导因子1α(HIF-1α)表达。使用Ussing小室测量跨上皮电阻(TER)和甘露醇通量。
结果 在4小时时,利多卡因并未持续减少缺血、操作或对照组织中的中性粒细胞浸润。利多卡因显著降低了操作组织中环氧化酶-2表达的环行肌和总体评分。在4小时时,操作组织中的HIF-1α表达明显低于对照组织。在4小时时从操作和对照段获得的黏膜的TER低于0小时时的对照组织,甘露醇通量更高。利多卡因并未显著降低钙卫蛋白表达。在4小时时,对照、缺血和操作组织中的中性粒细胞浸润严重程度相似。
结论及临床意义 与距操作、缺血和再灌注部位较远的4小时对照(未操作)空肠相比,操作的空肠中性粒细胞浸润增加并不显著。利多卡因并未持续减少空肠中的中性粒细胞浸润。