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脊髓镇痛对大鼠延髓尾部内脏伤害性神经元的影响。

The effect of spinal analgesia on visceral nociceptive neurons in caudal medulla of the rat.

作者信息

Ness T J, Piper J G, Follett K A

机构信息

Department of Anesthesiology, University of Alabama at Birmingham School of Medicine, 35233, USA.

出版信息

Anesth Analg. 1999 Sep;89(3):721-6. doi: 10.1097/00000539-199909000-00036.

Abstract

UNLABELLED

A population of neurons resident in the caudal ventrolateral medulla are excited by noxious cutaneous and visceral stimuli from large portions of the body. These neurons act as monitors of ascending nociceptive information, and we hypothesized that they would be inhibited by spinally administered analgesics in a clinically relevant fashion. Rats were anesthetized with oxygen/ halothane. The caudal medulla was surgically exposed, and a catheter placed into the intrathecal space overlying the lower thoracic spinal cord via the surgical site. Single medullary neurons were characterized for responses to cutaneous and visceral (colorectal distension) stimuli. The effects of i.v. and intrathecally administered morphine and lidocaine were determined. The intrathecal infusion of morphine for 6 days before testing was also used as a pretreatment. Colorectal distension-evoked responses of medullary nociceptive neurons were inhibited in a dose-dependent, naloxonereversible fashion by intrathecal and i.v. morphine (50% effective dose values: 3.5 and 440 microg/kg, respectively). Intrathecal lidocaine abolished responses to colorectal distension and produced a spinal level at doses producing minimal effects when administered systemically. Prior treatment with an infusion of morphine produced tolerance to the effects of subsequent intrathecal morphine administration. These findings support the use of this preparation as a neurophysiologic model of spinal analgesia.

IMPLICATIONS

Neurons in the brainstem, isolated electrophysiologically, were used as whole body monitors of pain-related activity in the rat. As a neurophysiologic model of nociception, this preparation may prove useful for the study of regionally administered analgesics and local anesthetics.

摘要

未标记

位于延髓尾端腹外侧的一群神经元,会被来自身体大部分部位的有害皮肤和内脏刺激所兴奋。这些神经元充当上行伤害性信息的监测器,我们推测它们会被脊髓给予的镇痛药以临床相关方式抑制。大鼠用氧气/氟烷麻醉。手术暴露延髓尾部,并通过手术部位将导管置于下胸段脊髓上方的鞘内空间。对单个延髓神经元对皮肤和内脏(结肠扩张)刺激的反应进行了表征。测定了静脉内和鞘内给予吗啡和利多卡因的效果。在测试前鞘内输注吗啡6天也用作预处理。鞘内和静脉内吗啡以剂量依赖性、纳洛酮可逆的方式抑制延髓伤害性神经元对结肠扩张诱发的反应(半数有效剂量值:分别为3.5和440微克/千克)。鞘内利多卡因消除了对结肠扩张的反应,并在全身给药产生最小作用的剂量下产生脊髓水平的作用。预先用吗啡输注治疗会产生对随后鞘内给予吗啡效果的耐受性。这些发现支持将该制剂用作脊髓镇痛的神经生理学模型。

启示

通过电生理分离的脑干神经元被用作大鼠疼痛相关活动的全身监测器。作为伤害感受的神经生理学模型,可以证明该制剂对于研究局部给药的镇痛药和局部麻醉药是有用的。

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