Effects of Splenic Sympathetic Nerve Blockade on the α7nAChR-Dependent Cholinergic Anti-Inflammatory Pathway
Objective To investigate the effects of splenic sympathetic nerve blockade on the α7nAChR-dependent cholinergic anti-inflammatory pathway in patients undergoing lobectomy.Methods 60 patients undergoing elective thoracoscopic lung surgery were selected and ipsilateral sympathetic nerve blocks were performed according to the surgical site.In the experimental group,30 left T7 paravertebral nerve blocks were performed to block the splanchnic sympathetic nerves;in the control group,30 right T7 paravertebral nerve blocks were performed to block the sympathetic nerves in the same plane.Ultrasound Doppler was used to detect the splenic artery resistance index(RI)before and after blockade in the 2 groups.The serum α7nAChR levels and the expression levels of inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factorα(TNF-α)]were detected by ELISA at preoperative(T1),30 min after the beginning of the surgery(T2),at the end of the surgery(T3),at 12 h after the surgery(T4),and at 24 h after the surgery(T5)in the 2 groups.Results Splenic Doppler ultrasound showed that the RI of the splenic artery was significantly lower in the experimental group compared with that before blockade(P＜0.05).Compared with the T1 time point,the serum α7nAChR level was significantly higher at the T5 time point in the experimental group(P＜0.05),and the serum IL-1β,IL-6,and TNF-α levels were significantly higher at the T4 and T5 time points in both groups(P＜0.05);the serum α7nAChR level in the experimental group was significantly higher than that in the control group at the T4 and T5 time points(P＜0.05),and the serum IL-1β,IL-6,and TNF-α levels were significantly lower than those of the control group(P＜0.05).Conclusions Splenic sympathetic nervous system block can activate the α7nAChR-dependent cholinergic anti-inflammatory pathway and reduce postoperative inflammatory response in patients undergoing pulmonary lobectomy.
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