Leem J W, Choi Y, Han S M, Yoon M J, Sim J Y, Leem S W
Department of Anesthesiology, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, Korea.
Reg Anesth Pain Med. 2000 Nov-Dec;25(6):620-5. doi: 10.1053/rapm.2000.16160.
Clonidine, an alpha(2)-adrenergic agonist, has been shown to prolong local anesthesia. It appears that clonidine by itself produces conduction block by acting on peripheral nerves. However, whether clonidine-induced conduction block is mediated through alpha(2)-adrenergic receptors remains unclear. The purpose of this study was to see if clonidine's nerve-blocking action was through alpha(2)-adrenergic receptors by examining clonidine's action in the presence of alpha(2)-adrenergic antagonists.
The compound action potentials (CAPs) evoked by electrical stimuli were recorded from the isolated rat sciatic nerve in a recording chamber. Conduction block was examined by analyzing CAPs with regard to peak amplitude and time-to-peak in the presence of clonidine alone or clonidine plus alpha(2)-adrenergic antagonist yohimbine or idazoxan.
Both clonidine and yohimbine produced concentration-dependent, reversible, conduction block. Based on concentration-response relationships, the 50% of effective concentration (EC(50)) were estimated to be 1.61 +/- 0.51 mmol/L (mean +/- SD) for clonidine and 51.4 +/- 27.2 micromol/L for yohimbine. A mixture of equal volumes of 2.07 mmol/L clonidine and 55.6 micromol/L yohimbine produced conduction block to a level close to the mean value between conduction blocks induced by 2.07 mmol/L clonidine alone and 55.6 micromol/L yohimbine alone. Addition of idazoxan, a more specific alpha(2)-adrenergic antagonist than yohimbine, to clonidine was without effect on clonidine-induced conduction block.
The results indicated that the mixture of clonidine and yohimbine, in which either drug inhibited impulse conduction, produced conduction block in an additive manner, and that clonidine-induced conduction block was not reversed by coapplication with a specific alpha(2)-adrenergic antagonist idazoxan. These data suggest that clonidine's effects likely depend on mechanisms not mediated by alpha(2)-adrenergic receptors.
可乐定作为一种α₂肾上腺素能激动剂,已被证实可延长局部麻醉时间。可乐定自身似乎可通过作用于外周神经产生传导阻滞。然而,可乐定诱导的传导阻滞是否通过α₂肾上腺素能受体介导仍不清楚。本研究的目的是通过检测可乐定在α₂肾上腺素能拮抗剂存在时的作用,来观察可乐定的神经阻滞作用是否通过α₂肾上腺素能受体介导。
在记录室中,从分离的大鼠坐骨神经记录电刺激诱发的复合动作电位(CAPs)。通过分析单独使用可乐定或可乐定加α₂肾上腺素能拮抗剂育亨宾或咪唑克生时CAPs的峰幅度和峰时间来检测传导阻滞。
可乐定和育亨宾均产生浓度依赖性、可逆性传导阻滞。根据浓度-反应关系,可乐定的半数有效浓度(EC₅₀)估计为1.61±0.51 mmol/L(平均值±标准差),育亨宾为51.4±27.2 μmol/L。等体积的2.07 mmol/L可乐定和55.6 μmol/L育亨宾混合产生的传导阻滞程度接近单独使用2.07 mmol/L可乐定和单独使用55.6 μmol/L育亨宾诱导的传导阻滞平均值。向可乐定中加入比育亨宾更具特异性的α₂肾上腺素能拮抗剂咪唑克生,对可乐定诱导的传导阻滞无影响。
结果表明可乐定和育亨宾的混合物(其中任何一种药物均可抑制冲动传导)以相加方式产生传导阻滞,且可乐定诱导的传导阻滞不会因与特异性α₂肾上腺素能拮抗剂咪唑克生共同应用而逆转。这些数据提示可乐定的作用可能依赖于非α₂肾上腺素能受体介导的机制。