Nishiyama Tomoki, Hanaoka Kazuo
From the Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, Tokyo, Japan.
Anesth Analg. 2004 Apr;98(4):1056-1061. doi: 10.1213/01.ANE.0000105877.07071.EF.
We investigated the interaction between spinally administered bupivacaine and clonidine using an animal model of acute and inflammatory pain. Rats implanted with lumbar intrathecal catheters were injected intrathecally with saline (control), bupivacaine (1 to 100 microg), or clonidine (0.1 to 3 microg) and tested for their responses to thermal stimulation to the tail (tail flick test) and subcutaneous formalin injection into the hindpaw (formalin test). The effects of the combination of bupivacaine and clonidine on both stimuli were tested by isobolographic analysis. General behavior and motor function were examined as side effects. The 50% effective doses of bupivacaine and clonidine were significantly smaller when combined compared with each single drug in both the tail flick test (2.82 and 0.11 microg versus 7.1 and 0.29 microg, respectively) and phase 1 (0.24 and 0.009 microg versus 5.7 and 0.15 microg) and phase 2 (0.31 and 0.012 microg versus 3.2 and 0.16 microg) of the formalin test. Side effects were decreased by the combination. These results suggest a favorable combination of intrathecal bupivacaine and clonidine in the management of acute and inflammatory pain.
The analgesic interaction between intrathecally administered bupivacaine and clonidine was examined during acute thermal and inflammatory-induced pain in rats. The analgesia produced by the combination of these two drugs was synergistic in both acute thermal and inflammatory induced pain, with a decrease in behavioral side effects.
我们使用急性和炎性疼痛动物模型研究了鞘内注射布比卡因和可乐定之间的相互作用。给植入腰段鞘内导管的大鼠鞘内注射生理盐水(对照)、布比卡因(1至100微克)或可乐定(0.1至3微克),并测试它们对尾部热刺激(甩尾试验)和后爪皮下注射福尔马林(福尔马林试验)的反应。通过等效应线分析测试布比卡因和可乐定联合使用对两种刺激的影响。检查一般行为和运动功能作为副作用。在甩尾试验(分别为2.82和0.11微克对7.1和0.29微克)以及福尔马林试验的第1阶段(0.24和0.009微克对5.7和0.15微克)和第2阶段(0.31和0.012微克对3.2和0.16微克)中,与每种单一药物相比,布比卡因和可乐定联合使用时的50%有效剂量显著更小。联合使用可减少副作用。这些结果表明鞘内注射布比卡因和可乐定在治疗急性和炎性疼痛方面有良好的联合效果。
在大鼠急性热痛和炎性诱导疼痛期间,研究了鞘内注射布比卡因和可乐定之间的镇痛相互作用。这两种药物联合产生的镇痛作用在急性热痛和炎性诱导疼痛中均具有协同作用,且行为副作用减少。