PDF(Pubmed)
Abstract：
Somatostatin (SST) released from capsaicin-sensitive sensory nerves in response to stimulation exerts systemic anti-inflammatory, analgesic actions. Its elevation correlates with the extent of tissue injury. We measured plasma SST alterations during spine operations (scoliosis and herniated disc) to determine whether its release might be a general protective mechanism during painful conditions. Sampling timepoints were baseline (1), after: soft tissue retraction (2), osteotomy (3), skin closure (4), the following morning (5). Plasma SST-like immunoreactivity (SST-LI) determined by radioimmunoassay was correlated with pain intensity and the correction angle (Cobb angle). In scoliosis surgery, postoperative pain intensity (VAS 2.) 1 day after surgery significantly increased (from 1.44 SEM ± 0.68 to 6.77 SEM ± 0.82, p = 0.0028) and positively correlated with the Cobb angle (p = 0.0235). The baseline Cobb degree negatively correlated (p = 0.0459) with the preoperative SST-LI. The plasma SST-LI significantly increased in fraction 3 compared to the baseline (p < 0.05), and significantly decreased thereafter (p < 0.001). In contrast, in herniated disc operations no SST-LI changes were observed in either group. The VAS decreased after surgery both in the traditional (mean 6.83 to 2.29, p = 0.0005) and microdiscectomy groups (mean 7.22 to 2.11, p = 0.0009). More extensive and destructive scoliosis surgery might cause greater tissue damage with greater pain (inflammation), which results in a significant SST release into the plasma from the sensory nerves. SST is suggested to be involved in an endogenous postoperative analgesic (anti-inflammatory) mechanism.
摘要：
从辣椒素敏感的感觉神经释放的生长抑素（SST）在刺激时发挥全身抗炎作用，镇痛作用。其升高与组织损伤的程度相关。我们测量了脊柱手术（脊柱侧凸和椎间盘突出）期间的血浆SST改变，以确定其释放是否可能是疼痛期间的一般保护机制。采样时间点为基线（1），之后：软组织回缩（2），截骨(3),蒙皮闭合(4),第二天早上（5）。通过放射免疫法测定的血浆SST样免疫反应性（SST-LI）与疼痛强度和校正角（Cobb角）相关。在脊柱侧弯手术中，术后疼痛强度（VAS2。)术后1天显著增加(从1.44SEM±0.68增加到6.77SEM±0.82,p=0.0028),且与Cobb角呈正相关(p=0.0235)。基线Cobb程度与术前SST-LI呈负相关(p=0.0459)。与基线相比，血浆SST-LI在分数3中显著增加(p<0.05)，此后显着降低（p<0.001）。相比之下,在椎间盘突出手术中,两组均未观察到SST-LI改变.传统（平均6.83至2.29，p=0.0005）和显微椎间盘切除术组（平均7.22至2.11，p=0.0009）术后VAS均降低。更广泛和破坏性的脊柱侧弯手术可能会导致更大的组织损伤和更大的疼痛（炎症），这导致从感觉神经到血浆中的显著SST释放。SST被认为与内源性术后镇痛（抗炎）机制有关。
