Veterans Research and Education Foundation, Oklahoma City VA Medical Center, Oklahoma City, OK, USA.
Department of Physiology, University of Oklahoma, Norman, OK, USA.
J Gastrointest Surg. 2019 Feb;23(2):320-330. doi: 10.1007/s11605-018-3969-5. Epub 2018 Sep 27.
Postoperative ileus (POI) is a heavy burden for healthcare industries and reduces the postoperative quality of life. The aim of this study was to investigate the effects and mechanisms of the intraoperative vagus nerve stimulation (iVNS) on gastrointestinal motility in a rodent model of POI.
For control group (control, n = 8), electrodes were placed on the chest wall for recording the electrocardiogram and on the stomach and small intestine for measuring gastric slow waves (GSWs) and small intestinal slow waves (SSWs). For sham group (sham, n = 8) and iVNS group (VNS, n = 8), after the same surgery as the control, intestinal manipulation (IM) was performed to induce POI. iVNS was performed during the surgery for the iVNS group. Small intestinal transit (SIT), gastric emptying (GE), postoperative pain, and plasma TNF-α were evaluated after operation.
IM delayed GE that was normalized by iVNS (P < 0.05). iVNS reduced plasma TNF-α increased by IM (P = 0.04). iVNS prevents the injury of ileum mucosa induced by IM (P < 0.05). iVNS reduced the postoperative pain (P < 0.05). iVNS prevented the IM-induced decrease in vagal activity (sham 0-30 min vs. 150-180 min, P = 0.03, VNS 0-30 min vs. 150-180 min, P = 0.58) and increase in sympathovagal balance (sham 0-30 min vs. 150-180 min, P = 0.04, VNS 0-30 min vs. 150-180 min, P = 0.72).
iVNS accelerates postoperative recovery by improving GE, reducing postoperative pain, and preventing the injury of ileum mucosa mediated via the autonomic mechanisms.
术后肠麻痹（POI）给医疗保健行业带来了沉重负担，并降低了术后生活质量。本研究旨在探讨术中迷走神经刺激（iVNS）对 POI 模型中胃肠道动力的影响及其机制。
对于对照组（control，n=8），将电极放置在胸壁上以记录心电图，放置在胃和小肠上以测量胃慢波（GSWs）和小肠慢波（SSWs）。对于假手术组（sham，n=8）和 iVNS 组（VNS，n=8），在进行与对照组相同的手术后，进行肠道操作（IM）以诱导 POI。在手术过程中对 iVNS 组进行 iVNS。术后评估小肠转运（SIT）、胃排空（GE）、术后疼痛和血浆 TNF-α。
IM 延迟了 GE，而 iVNS 使其正常化（P<0.05）。iVNS 降低了 IM 引起的血浆 TNF-α增加（P=0.04）。iVNS 可防止 IM 引起的回肠黏膜损伤（P<0.05）。iVNS 减轻了术后疼痛（P<0.05）。iVNS 防止了 IM 引起的迷走神经活动减少（sham 0-30 分钟 vs. 150-180 分钟，P=0.03，VNS 0-30 分钟 vs. 150-180 分钟，P=0.58）和交感神经-迷走神经平衡增加（sham 0-30 分钟 vs. 150-180 分钟，P=0.04，VNS 0-30 分钟 vs. 150-180 分钟，P=0.72）。
iVNS 通过改善 GE、减轻术后疼痛和预防回肠黏膜损伤来加速术后恢复，这是通过自主机制介导的。
