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冷冻镇痛的机制研究

Mechanism research of cryoanalgesia.

作者信息

Zhou L, Kambin P, Casey K F, Bonner F J, O'Brien E, Shao Z, Ou S

机构信息

Department of Orthopaedics, Graduate Hospital, Philadelphia, PA, USA.

出版信息

Neurol Res. 1995 Aug;17(4):307-11. doi: 10.1080/01616412.1995.11740333.

Abstract

The sciatic nerves of rabbits were frozen at different temperatures (-20 degrees C, -60 degrees C, -100 degrees C, -140 degrees C, and -180 degrees C). The morphology and function of the frozen nerves were examined with light microscopy (hematoxylin and eosinophilin stain and a histochemical thiocholine method) and electron microscopy. The function of the nerve after freezing was assessed using short latency somatosensory evoked potentials, sensory conduction velocity, and electromyogram at various intervals after freezing. There were no changes in morphology or function of nerves cryolesioned at -20 degrees C. The nerve fibers cryolesioned at -60 degrees C showed signs of freezing degeneration and lost their conductive function although, these nerves all recovered. Approximately half of nerve fibers cryolesioned at -100 degrees C showed Wallerian degeneration, and although the time to remyelination was delayed, nerve regeneration was still complete. At -140 degrees C and -180 degrees C the nerve fibers showed immediate necrosis, with destruction of basal membranes and proliferation of collagen fibers. The results explained the mechanism of cryoanalgesia. Our study demonstrates that cryo-temperatures lower than -140 degrees C will cause permanent alterations in nerve morphology and function, whereas warmer temperatures do not result in permanent nerve damage and are therefore not likely to provide long-term analgesia to patients.

摘要

将兔的坐骨神经在不同温度(-20℃、-60℃、-100℃、-140℃和-180℃)下冷冻。采用光学显微镜(苏木精-伊红染色和组织化学硫代胆碱法)和电子显微镜检查冷冻神经的形态和功能。在冷冻后的不同时间间隔,使用短潜伏期体感诱发电位、感觉传导速度和肌电图评估神经冷冻后的功能。在-20℃冷冻损伤的神经在形态和功能上没有变化。在-60℃冷冻损伤的神经纤维出现冷冻变性迹象并失去传导功能,不过这些神经均恢复了。在-100℃冷冻损伤的神经纤维约有一半出现华勒变性,虽然髓鞘再生时间延迟,但神经仍完全再生。在-140℃和-180℃时,神经纤维立即坏死,基底膜破坏,胶原纤维增生。这些结果解释了冷冻镇痛的机制。我们的研究表明,低于-140℃的冷冻温度会导致神经形态和功能的永久性改变,而较高温度不会导致永久性神经损伤,因此不太可能为患者提供长期镇痛效果。

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