鞘内注射小剂量纳洛酮、吗啡和芬太尼对切口痛大鼠脊髓胃动素表达的影响  

Effects of intrathecal low-dose naloxone, morphine and fentanyl on expression of motilin in spinal cord in rats with incisional pain

作　　者：赵军[1] 高宝柱[1] 郑宝森[2] 曹君利[3] 刘鹤[3] 于常州[3] 刘功俭[3] 

机构地区：[1]天津市第三中心医院麻醉科, 300170 [2] 天津医科大学第二医院疼痛治疗中心 [3] 徐州医学院江苏省麻醉与镇痛应用技术重点实验室

出　　处：《中华麻醉学杂志》2013年第12期1443-1446,共4页Chinese Journal of Anesthesiology

基　　金：基金项目：天津市卫生局科技基金（2010KZ19）

摘　　要：目的 评价鞘内注射小剂量纳洛酮、吗啡和芬太尼对切口痛大鼠脊髓胃动素（MTL）表达的影响.方法 健康雄性SD大鼠72只,体重180 ～ 220 g,采用随机数字表法,将其分为6组（n=12）：生理盐水组（NS组）、吗啡＋芬太尼组（MF组）、切口痛组（P组）、纳洛酮＋切口痛组（NP组）、吗啡＋芬太尼＋切口痛组（MFP组）、吗啡＋芬太尼＋纳洛酮＋切口痛组（MFNP组）.于右足跖肌切口制备切口痛模型,制备切口痛模型前20 min时MF组、MFP组和MFNP组鞘内注射吗啡5 μg/kg＋芬太尼0.25 g/kg混合液,NP组和MFNP组给予纳洛酮1 ng/kg.各组取6只大鼠,分别于鞘内置管前（T0,基础状态）、造模前24h（T1）、术后1、3、6 h（T2-4）时测定机械缩足反应阈（PWMT）与热缩足反应潜伏期（PWTL）.各组另取6只大鼠,于术后6h时取脊髓、胃体和二十指肠,采用ELISA法检测MTL含量.结果 与To时比较,MF组T3时PWMT升高,T22-4时PWTL延长,P组T22-4时PWMT降低,PWTL缩短,NP组T3,4时PWMT降低,PWTL缩短,MFP组T2,3时PWMT升高,MFNP组T2时PWMT升高,PWTL延长（P＜0.05）;与NS组比较,MF组和NP组脊髓和胃体MTL含量降低,MF组十二指肠MTL含量降低,NP组十二指肠MTL含量升高,P组和MFP组脊髓MTL含量升高,胃体MTL含量降低,P组十二指肠MTL含量升高,MFP组十二指肠MTL含量降低（P＜0.05）,MFNP组上述指标差异无统计学意义（P＞0.05）.结论 鞘内注射小剂量纳洛酮与吗啡和芬太尼联合应用可抑制切口痛大鼠脊髓MTL表达上调,进而参与维持胃肠动力的稳定.Objective To evaluate the effects of intrathecal low-dose naloxone,morphine and fentanyl on the expression of motilin （MTL） in the spinal cord in rats with incisional pain.Methods Seventy-two healthy male Sprague-Dawley rats,weighing 180-220 g,in which intrathecal catheters were successfully implanted,were randomly divided into 6 groups （n =12 each） using a random number table：normal saline group （NS group）,morphine ＋ fentanyl group （MF group）,incisional pain group （P group）,naloxone ＋ incisional pain group （NP group）,morphine ＋ fentanyl ＋ incisional pain group （MFP group）,and morphine ＋ fentanyl ＋ naloxone ＋incisional pain group （MFNP group）.Incisional pain was induced by an incision made into the plantar surface of the right hindpaw.At 20 min before induction of incisional pain,the mixture of morphine 5 μg/kg and fentanyl 0.25 μg/kg was injected intrathecally in MF,MFP and MFNP groups,and naloxone 1 ng/kg was given in NP and MFNP groups.Six rats from each group were randomly chosen,and paw withdrawal threshold to mechanical stimulation （PWMT） and paw withdrawal latency to thermal stimuli （PWTL） were measured before intrathecal catheterization （T0,baseline）,at 24 h before induction of incisional pain （T1）,and at 1,3 and 6 h after induction of incisional pain （T2-4）.The left 6 rats from each group were chosen and sacrificed and the spinal cord were removed at 6 h after operation for detection of MTL content in the spinal cord,body of the stomach and duodeum tissues （by ELISA）.Results Compared with the baseline value at T0,PWMT was significantly increased at T3,and PWTL was prolonged at T2-4 in MF group,PWMT was decreased and PWTL was shortened at T2-4 in P group and at T3,4 in NP group,PWMT was increased at T2,3 in MFP group,and PWMT was increased and PWTL was prolonged at T2 in MFNP group （P 〈 0.05）.Compared with NS group,MTL contents in spinal cord and body of the stomach were significantly decreased in MF and NP groups,MTL cortent

关 键 词：纳洛酮 吗啡 芬太尼 注射 脊髓 促胃动素 脊髓 疼痛 手术后 

分 类 号：R614[医药卫生—麻醉学]