国际麻醉学与复苏杂志   2015, Issue (2): 3-3
    
不同剂量瑞芬太尼停药后对大鼠热痛觉阈值的影响
蔡清香, 雷洪伊, 徐世元1()
1.广州中医药大学第一附属医院
The effects of different doses of remifentanil on the threshold of heat stimulus in rats during withdrawal
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摘要:

目的 探讨静脉持续输注不同剂量瑞芬太尼停药后对大鼠热痛觉阈值的影响,观察其与剂量的关系。 方法40只健康雄性SD大鼠,采用随机数字表法分为5组,每组8只,建立颈静脉输液模型,R1、R2、R3、R4组分别通过颈静脉持续输注瑞芬太尼0.3、0.6、1.0、1.5 μg·kg-1·min-1,N组(对照组)输注生理盐水0.1 ml·kg-1·min-1共4 h。各组分别于模型前(T1),模型后(T2),停药后0.5(T3)、1(T4)、2(T5)、24(T6)、48 h(T7)测量大鼠热痛觉阈值。 结果 颈静脉置管前后,大鼠热痛觉阈值比较差异无统计学意义(P>0.05);T3时点,各组阈值均降至最小,R4组(3.3±0.3) s、R3组(3.6±0.5) s、R2组(3.9±0.3) s和R1组(4.2±0.9) s阈值较T2时点分别降低34.0%、30.8%、13.3%和10.6%,较N组(4.6±0.4) s分别降低28.3%、21.7%、15.2%和8.7%; T4时点,R4组(3.5±0.4) s、R3组(3.7±0.4) s、R2组(4.0±0.4) s和R1组(4.2±0.8) s阈值较T2时点分别降低30.0%、26.0%、11.1%和10.6%,R4组和R3组,在T3[(3.3±0.3)、(3.6±0.5) s]、 T4[(3.5±0.4)、(3.7±0.4) s]和T5[(3.9±0.4)、(4.2±0.7) s]时点较T2[(5.0±0.6)、(5.2±0.8) s]时点明显降低,差异有统计学意义(P<0.05);R2组和R1组T5时点阈值[(4.2±0.6)、(4.4±0.9) s]较T2时点阈值降低6.7%和6.4%;其余与T2比较,差异无统计学意义(P>0.05)。 结论 静脉持续输注瑞芬太尼停药后出现痛觉过敏(opioid-induced hyperalgesia, OIH),输注剂量越大,其热痛觉阈值下降程度越大,OIH越强。

关键词: 瑞芬太尼; 疼痛
Abstract:

Objective To evaluate the effects of different doses of remifentanil on pain threshold in rats during withdrawal. Methods Forty adult male SD rats were randomly divided into 5 groups(n=8), the model of long-term vascular access to mouse was established. The rats in remifentanil groups (R1, R2, R3 and R4 group) were injected with remifentanil 0.3, 0.6, 1.0 μg·kg-1·min-1, and 1.5 μg·kg-1·min-1 through jugular vein. The rats in saline group (N group) were injected with 0.1 ml·kg-1·min-1 normal saline through jugular vein. All rats were continuously exposed to remifentanil or saline for 4 h. The response to thermal noxious stimulation was determined before and after model establishment, 0.5, 1, 2, 24, 48 h after remifentanil withdrawal (treatment groups) and saline (control group)(T1-T7). Results There is no significant difference in baseline threshold of heat stimulus after jugular vein catheterization in rats. The threshold of heat stimulus reached the minimum level at half an hour after remifentanil withdrawal. The threshold of heat stimulus decreased by 34.0%, 30.8%, 13.3% and 10.6% on T3 in R4(3.3±0.3) s, R3(3.6±0.5) s, R2(3.9±0.3) s and R1(4.2±0.9) s group, and decreased by 28.3%, 21.7%, 15.2% (P<0.05), 8.7% than that in N group (4.6±0.4) s (P<0.05). The threshold of heat stimulus decreased by 30.0%, 26.0%, 11.1%, 10.6% in R4(3.5±0.4) s, R3(3.7±0.4) s, R2(4.0±0.4) s and R1(4.2±0.8) s group on T4 than that on T2(P<0.05). Compared with T2, the threshold of heat stimulus on T3[(3.3±0.3), (3.6±0.5) s], T4[(3.5±0.4), (3.7±0.4) s] and T5[(3.9±0.4), (4.2±0.7) s] significantly increased in R4 and R3 groups(P<0.05). There exist no diffference in the others. Conclusions Different doses of remifentanil infusion can result in acute hyperalgesia higher dose, the greater the extent of pain threshold decline.

Key words: Remifentanil; Pain