国际麻醉学与复苏杂志   2013, Issue (5): 7-7
    
不同剂量受体拮抗剂CTOP对瑞芬太尼诱发痛觉过敏的影响
师瑾, 薛朝霞, 胡古月, 吕晓敏, 张鹏1()
1.山西医科大学
The effect of remifentanil-induced hyperalgesia by different dose of -receptor antagonist CTOP
 全文:
摘要:

目的 观察不同剂量的CTOP对瑞芬太尼引起的切口痛大鼠痛觉过敏的影响。 方法 采用完全随机法将30只SD雄性大鼠随机为5组(每组6只):正常组(A组);切口痛组(B组);切口痛+瑞芬太尼组(C组);切口痛+瑞芬太尼+CTOP低剂量组(D组);切口痛+瑞芬太尼+CTOP高剂量组(E组)。各组大鼠测定基础状态下(T0)的热缩足反射潜伏期(paw withdrawal thermal latency,PWTL)后,以5%水合氯醛350 mg/kg大鼠腹腔麻醉,A、B、C组尾静脉注射生理盐水0.4 ml,D、E组分别注射CTOP 0.5 μg/kg、0.5 mg/kg,溶于0.4 ml生理盐水内。给药结束10 min后,除A组外全部于右后爪做切口,同时由尾静脉以0.8 ml/h的速度40 μg/kg的剂量分别给A、B组泵生理盐水,C、D、E组泵瑞芬太尼,各30 min。术后2(T1)、24 h(T2)测定PWTL后处死大鼠取脊髓,用酶联免疫法(ELISA)测定强啡肽表达。 结果 T1、T2时间点C组PWTL结果[(10.23.0),(6.22.6)s]与A组[(13.32.4),(13.42.2)s]、B组[(13.52.7),(11.54.1)s]比较,差异有统计学意义(P<0.05),PWTL时间缩短;且C组强啡肽结果(172±17)ng/L与A、B组(78±9)、(120±10)ng/L比较,差异有统计学意义(P<0.05),强啡肽表达增多;D、E两组T2的PWTL值和强啡肽结果与C组比较,差异均有统计学意义,PWTL时间延长,强啡肽表达减少;D、E两组强啡肽表达相比,差异有统计学意义(P<0.05)。 结论 在大鼠切口痛模型中,瑞芬太尼导致了切口周围组织痛觉过敏;应用受体拮抗剂可以缓解痛觉过敏,低剂量的效果更加显著。

关键词: 瑞芬太尼;痛觉过敏;切口痛;受体拮抗剂;强啡肽
Abstract:

Objective To investigate the effect of different dose of -receptor antagonist CTOP on remifentanil-induced hyperalgesia in incisional pain rat model by observing rats' paw withdrawal thermal latency(PWTL)and the dynorphin expression in spinal cord. Methods Thirty male SD rats were randomly divided into 5 groups (n=6): control group (A), incisional pain group (B), incisional pain + remifentanil group (C), incisional pain + remifentanil + CTOP lower dose group (D), incisional pain + remifentanil + CTOP higher dose (E). All rats were anesthetized with intraperitoneal 5% chloral hydrate(350 mg/kg). Ten min after administered intravenously with 0.4 ml saline in group A, group B and group C, with 0.5 μg/kg CTOP in group D and 0.5 mg/kg CTOP, rats in all groups except group A were underwent right hind paw surgery. Meanwhile, rats in group A and group B were infused intravenously with saline,and rats in group C, group D and group E were infused intravenously with remifentanil of 40 μg/kg by lasting 30 min. 24 h(T2) later,24 h later, all rats were sacrificed and spinal cord tissues were separated for detecting the expression of dynorphin by ELISA. PWTL was tested at time before anaesthesia (T0), 2 h (T2) and 24 h (T2) after paw surgery. Results PWTL were significantly lower in group C [(10.2±3.0) s at T1 and (6.2±2.6)s at T2] than that in group A [(13.3±2.4)s at T1 and (13.4±2.2) s at T2]and group B[(13.5±2.7s at T1 and (11.5±4.1)s at T2] compared with group A. Dynorphin expression in group C(172±17)ng/Lwere higher than that in group A (78±9)ng/Land group B(120±10)ng/L (P <0.05). Compared with group C,PWTL were higher and dynorphin were lower significantly in group D and E (P<0.05). There were different in the dynorphin expression between group D and group E. Conclusions In rat model of incisional pain, remifentanil could enhance postoperative pain, -receptor antagonist (CTOP) could reduce the hyperalgesia induced by remifentanil and the lower dose is more effective.

Key words: Remifentanil; Hyperalgesia; Incision pain; CTOP; Dynorphin