不同剂量μ受体拮抗剂CTOP对瑞芬太尼诱发痛觉过敏的影响  

The effect of remifentanil4nduced hyperalgesia by different dose ofμ-receptor antagonist CTOP

作　　者：师瑾[1] 薛朝霞[2] 胡古月[1] 吕晓敏[1] 张鹏[1] 

机构地区：[1]山西医科大学,太原030001 [2]山西医科大学附属第一医院

出　　处：《国际麻醉学与复苏杂志》2013年第5期413-415,428,共4页International Journal of Anesthesiology and Resuscitation

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）。测定各组大鼠基础状态下（T0）的热缩足反射潜伏期（pawwithdrawalthermallatency，PWrL）后，以5％水合氯醛350mg／kg大鼠腹腔麻醉，A、B、C组尾静脉注射生理盐水0．4ml，D、E组分别注射CTOP0．5μg／kg、0．5mg／kg，溶于0．4ml生理盐水内。给药结束10min后，除A组外全部于右后爪做切口，同时由尾静脉以0．8ml／h的速度40μg／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30min。术后2（T1）、24h（T2）测定PWTL，处死大鼠取脊髓，用酶联免疫法（EusA）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）ns／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的冈汀L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两组强啡肽表达比较，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；应用斗受体拮抗剂可以缓解痛觉过敏，低剂量的效果更加显著。Objective To investigate the effect of different dose of μ-receptor antagonist CTOP on remifentanil-induced hyperalgesia in ineisional 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±2.7） s 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/L and 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 ineisional pain, remifentanil could enhance postoperative pain, μ-receptor antagonist（CTOP）could reduce

关 键 词：瑞芬太尼 痛觉过敏 切口痛 受体拮抗剂 强啡肽 

分 类 号：R614[医药卫生—麻醉学]