国际麻醉学与复苏杂志   2010, Issue (2): 115-118
    
氯胺酮预防瑞芬太尼痛觉过敏的实验研究
吴晓丽 马正良 顾小萍 崔松勤1()
1.221002,江苏省麻醉学重点实验室﹠徐州医学院江苏省麻醉医学研究所(吴晓丽、崔松勤);南京大学医学院附属鼓楼医院麻醉科(马正良、顾小萍)
Effects of pretreatment with ketamine on the hyperalgesia induced by remifentanil
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摘要:

目的 观察预先皮下注射氯胺酮对瑞芬太尼诱发切口痛模型大鼠痛觉过敏的影响。方法 雄性SD大鼠60只,将大鼠随机分为5组:对照组(C组)、切口痛组(I组)、氯胺酮(K组) 、瑞芬太尼组(R组)、氯胺酮+瑞芬太尼组(K+R组)。I, K, R 和 K+R组行右后足跖肌切口;K组和K+R 组术前单次皮下注射氯胺酮0.1 ml (10 mg/kg);R组和K+R 组切皮开始同时皮下泵注瑞芬太尼0.4 ml (0.04 mg/kg),泵注时间为30 min,所有动物手术和接受微量泵皮下输注均在吸入七氟醚麻醉下进行。于术前24 h、术后2、6、24、48 h检测痛行为学指标,包括机械缩足阈值(paw withdrawal mechanical threshold, PWMT)和热缩足反射潜伏期(paw withdrawal thermal latency, PWTL)。 结果 与 C 组和基础值比较,I 组术后各时间点 PWMT 和 PWTL 均降低(P约0.05);与 I 组相比,R组术后2h PWMT(6.48±1.23)g 和PWTL(11.13±1.95)s即开始降低,此水平持续至术后 48h(P约0.05);K+R组术后各时间点PWMT(9.36±1.76,9.41±1.50,10.18±1.42,10.15±1.48)g和PWTL(15.66±2.42,16.24±2.55,15.13±3.07,15.66±2.44)s均高于 R 组(P约0.05)。结论 术前预先皮下注射氯胺酮可有效预防瑞芬太尼诱发的切口痛模型大鼠痛觉过敏。

关键词: 氯胺酮;瑞芬太尼;切口痛;痛觉过敏;NMDA受体
Abstract:

Objective To investigate the effects of ketamine on the hyperalgesia induced by remifentanil in a rat model of postoperative pain. Methods sixty SD rats were randomly divided into 5 groups(n=12 each):control group (C); incisional pain group (I); ketamine group (K); remifentanil group (R); ketamine+ remifentanil group (K+R). A right hind paw plantar incision was performed in groupI, K, R and K+R. ketamine (10 mg/kg) was injected subcutaneously 30 min before plantar incision In group K and K+R. In group R and K+R ,remifentanil (0.04 mg/kg) were infused subcutaneously with a pump for 30 min at the moment of surgical incision. All rats were anesthetized with sevoflurane. The paw withdrawal mechanical threshold(PWMT)and paw withdrawal thermal latency(PWTL) were used to evaluate the behavioral changes and measured at 24 h before incision and at 2 h,6 h,24 h and 48 h after incision. Results Results Compared with group C and baseline, the decrease of PWMT and PWTL were observed at 2, 6, 24, 48 h after incision in groupI;Compared with group I, the significant decrease of PWMT(6.48±1.23 g) and PWTL(11.13±1.95 s) were observed at 2 h after incision in group R, and this level continued until 48 h after incision; Compared with group R, the significant increase of PWMT(9.36±1.76,9.41±1.50,10.18±1.42,10.15±1.48)g and PWTL(15.66±2.42,16.24±2.55, 15.13±3.07, 15.66±2.44)s were observed at 2 h,6 h,24h and 48 h after incision in group K+R. Conclusion ketamine pretreatment prevents the development of hyperalgesia induced by remifentanil in a rat model of postoperative pain.Conclusion ketamine pretreatment prevents the development remifentanil-induced hyperalgesia in postoperative paina rat model.

Key words: Ketamine ;Remifentanil;Postoperative pain;Hyperalgesia ;NMDA receptors