对芬太尼镇痛靶区主导地位的探索  

Experimental study of the dominant site of analgesic effect on target of fentanyl

作　　者：耿智隆[1] 张宏[2] 张志鉴[2] 

机构地区：[1]兰州军区兰州总医院麻醉科,甘肃兰州730050 [2]解放军总医院麻醉科,北京100853

出　　处：《西北国防医学杂志》2001年第4期360-362,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的 :经静脉或蛛网膜下腔注入芬太尼 ,探讨两种给药途径抑制伤害性刺激的作用部位。方法 :30只兔随机分为 5组 ,组Ⅰ和Ⅱ蛛网膜下腔分别注入芬太尼 10 μg和 2 5 μg;组Ⅲ、Ⅳ和Ⅴ分别静注芬太尼 10、2 0、30 μg·kg-1。实验兔均在局麻下行蛛网膜下腔置管。对兔尾根部行伤害性电刺激来观察兔体动反应。结果 :各组给药后对电刺激所致兔体动反应均有不同程度的抑制。静脉组镇痛完善及镇痛不全的持续时间均较蛛网膜下腔组明显短暂 (P <0 .0 1)。结论 :①蛛网膜下腔注入芬太尼 ,药物直接与脊髓背角阿片受体结合 ,产生抗伤害性刺激作用 ;②静脉注入不同剂量芬太尼通过药物与脊髓以上各靶区位点的阿片受体结合后 。Objective:To discuss where were the dominant target sites of analgesic of fentanyl after intravenous or intrathecal fentanyl administration in rabbits.Methods:Thirty adult rabbits were randomly divided into five groups:group Ⅰand Ⅱreceiving intrathecal fentanyl 10 μg and 25 μg;group Ⅲ,Ⅳ and Ⅴ receiving intravenous fentanyl 10 μg·kg -1 ,20 μg and 30 μg·kg -1 respectively.Motor responses were then observed when the base of the rabbit tail was stimulated with subcutaneous electrical current(50 volt at 50Hz for 10 sec).Results:Motor responses to electrical stimulus had different degree inhibition in all groups after fentanyl administration.In five groups,the numbers of rabbit of complete inhibiting motor response to electrical stimulus were as follows:2,5,5,6 and 6 rabbits,respectively.The durations of analgesia were shorter in intravenous groups than in intrathecal groups( P <0.01).Conclusion:①After intrathecal fentanyl administrated,fentanyl bindes to opiate receptors located in spinal dorsal horn to produce the effect of inhibiting motor responses to noxious stimuli.②After intravenous administrated fentanyl bolus,fentanyl binds to opiate receptors located in supraspinal regions to produce the effect of inhibiting motor responses to noxious stimuli by decending modulatory system as a vehicle.

关 键 词：麻醉学 芬太尼 镇痛 蛛网膜下腔 静脉注入 

分 类 号：R614.1[医药卫生—麻醉学]