预先腹腔联合注射曲马多与对乙酰氨基酚部分抑制大鼠L_5脊神经结扎后神经病理性疼痛的形成  

Preemptive intraperitoneal administration of tramadol and acetaminophen partially inhibits the development of neuropathic pain induced by L_5 spinal nerve ligation in rats

作　　者：管忍[1] 刘健[2] 谢蔚影[3] 徐建国[2] 

机构地区：[1]上海市交通大学医学院附属新华医院崇明分院麻醉科,上海医学博士研究生202150 [2]南京军区南京总医院麻醉科,南京210002 [3]浙江医科大学附属第二人民医院麻醉科,杭州202150

出　　处：《医学研究生学报》2010年第3期233-236,共4页Journal of Medical Postgraduates

基　　金：南京军区"十一五"重点课题基金(06239)

摘　　要：目的神经病理性疼痛是由中枢或外周神经系统损伤或疾病引起的疼痛综合征,临床起因广泛,病理机制复杂,症状多样,常规的单一的药物治疗对神经病理性疼痛均无明显的效果。文中旨在观察腹腔预先联合注射曲马多与对乙酰氨基酚对大鼠L5脊神经结扎后神经病理性疼痛形成的影响。方法健康成年雄性SD大鼠150只,体重250～300 g,出生10～15周,制备成L5脊神经部分结扎神经病理性疼痛模型后随机分为5组(n=30):假手术组(S组)、等渗盐水对照组(C组)、曲马多20 mg/kg(T组)、对乙酰氨基酚160 mg/kg(P组)、曲马多20 mg/kg+对乙酰氨基酚160 mg/kg(T+P组),每组分别向腹腔注射相应药物,2次/d,并于手术当天及术后第1、3、7、11、14、21天,分别测定大鼠的机械性缩足反射阈值(mechani-cal withdrawal threshald,MWT)和热缩足潜伏期(thermal withdrawal lateney,TWL)值。结果L5脊神经损伤术后4组大鼠均出现明显的机械痛觉超敏和热痛觉过敏症状;与对照组相比,手术当天即开始连续给与曲马多+对乙酰氨基酚能预防性减轻疼痛行为学表现,以术后第1天至第7天最明显(P<0.01);与假手术组相比,MWT和TWL值差异无统计学意义(P>0.05)。结论预先联合给与曲马多和对乙酰氨基酚可减轻神经病理性疼痛的发生程度,但并不能完全阻断大鼠神经病理性疼痛的产生。Objective Neuropathic pain is a pain syndrome induced by injuries or diseases in the central or peripheral nervous system, with complicated and varied pathomechanisms and symptoms, and it does not respond well to conventional single medication. This experiment was to observe the effect of preemptive intraperitoneal administration of tramadol combined with acetaminophen on the development of neuropathic pain induced by L5 spinal nerve ligation （SNL） in rats. Methods Models of neuropathie pain induced by L5 SNL were established in 150 adult male SD rats weighing 250 - 320g and randomized into 5 groups of equal number： shamoperation, saline control, tramadol 20 mg/kg （T）, acetaminophen 160 mg/kg （A）, and tramadol 20 mg/kg ＋ acetaminophen 160 mg/kg （ T ＋ A）. Each group received intraperitoneal injection of corresponding drug after surgery twice daily for 7 days. The mechanical withdrawal threshold （MWT） and thermal withdrawal latency （TWL） of the hind paw were measured at 1, 3, 7, 11, 14 and 21 d after surgery. Results Conspicuous symptoms of mechanical allodynia and thermal hyperalgesia were observed in all the rats following spinal nerve injury. Compared with the saline control, T ＋ A obviously lessened the ethological manifestation of neuropathic pain, most significantly at 1 - 7 d （P 〈 0.01 ）. There were no significant differences in the variances of MWT and TWL between the sham-operation and neuropathic pain rats （ P 〉 0. 05 ）. Conclusion Preemptive intraperitoneal administration of tramadol and acetaminophen could lessen the severity of mechanical allodynia and thermal hyperalgesia, but could not completely inhibit the development of neuropathic pain in the rat models of L5 spinal nerve ligation.

关 键 词：疼痛 脊神经 预先镇痛 曲马多 对乙酰氨基酚 大鼠 

分 类 号：R614.4[医药卫生—麻醉学]