Campos Adriana Rolim, Santos Flávia Almeida, Rao Vietla Satyanarayana
Departament of Physiology and Pharmacology, Federal University of Ceara (FM), Brazil.
Biol Pharm Bull. 2006 Jan;29(1):86-9. doi: 10.1248/bpb.29.86.
Ketamine is known to improve opioid efficacy, reduce postoperative opioid requirement and oppose opioid associated pain hypersensitivity and tolerance. However, the mechanisms underlying these beneficial effects are not clear. This study investigated the effects of ketamine at a non-analgesic dose (30 mg/kg, i.p.) on analgesia induced by morphine (2.5, 5.0, 7.5 mg/kg, s.c.), using rat tail-flick test as an animal model of acute pain. Further, the role of opioid-, alpha2-adrenoceptors and ATP-sensitive potassium channels was examined on the potentiating effect of ketamine. Male rats received morphine alone at 5.0 and 7.5 but not at 2.5 mg/kg showed a dose-related increase in tail-flick latencies. The combination of morphine and ketamine resulted in dose-related increase in morphine analgesia, both on the intensity as well as on duration. The ketamine-induced potentiation of morphine (7.5 mg/kg) analgesia was unaffected by glibenclamide (3 mg/kg, s.c.) and only partially blocked by yohimbine (2 mg/kg, i.p.), but more completely abolished by naloxone (2 mg/kg, i.p.). Both morphine (5.0 mg/kg) and ketamine (30 mg/kg) alone did not evoke catalepsy in rats but on combination produced a synergistic effect, which was however, abolished by naloxone pretreatment. In the open-field test, while morphine (5.0 mg/kg) caused a depressant effect, ketamine (30 mg/kg) enhanced the locomotor activity. Nevertheless, in combination potentiated the morphine's depressant effect on locomotion, which was also antagonized by naloxone. These results indicate that ketamine at a non-analgesic dose can potentiate morphine analgesia, induce catalepsy and cause locomotor depression, possibly involving an opioid mechanism. This potentiation, although favorable in acute pain management, may have some adverse clinical implications.
已知氯胺酮可提高阿片类药物的疗效,减少术后阿片类药物的用量,并对抗阿片类药物相关的疼痛超敏反应和耐受性。然而,这些有益作用背后的机制尚不清楚。本研究以大鼠甩尾试验作为急性疼痛的动物模型,研究了非镇痛剂量(30mg/kg,腹腔注射)氯胺酮对吗啡(2.5、5.0、7.5mg/kg,皮下注射)诱导的镇痛作用的影响。此外,还研究了阿片受体、α2-肾上腺素能受体和ATP敏感性钾通道在氯胺酮增强作用中的作用。雄性大鼠单独接受5.0和7.5mg/kg而非2.5mg/kg吗啡时,甩尾潜伏期呈剂量相关增加。吗啡与氯胺酮联合使用导致吗啡镇痛作用在强度和持续时间上均呈剂量相关增加。氯胺酮诱导的吗啡(7.5mg/kg)镇痛增强作用不受格列本脲(3mg/kg,皮下注射)影响,仅部分被育亨宾(2mg/kg,腹腔注射)阻断,但被纳洛酮(2mg/kg,腹腔注射)更完全地消除。单独使用吗啡(5.0mg/kg)和氯胺酮(30mg/kg)均未引起大鼠僵住,但联合使用产生协同作用,然而,纳洛酮预处理可消除该作用。在旷场试验中,吗啡(5.0mg/kg)产生抑制作用,而氯胺酮(30mg/kg)增强运动活性。然而,联合使用时增强了吗啡对运动的抑制作用,纳洛酮也可拮抗该作用。这些结果表明,非镇痛剂量的氯胺酮可增强吗啡镇痛作用、诱导僵住并引起运动抑制,可能涉及阿片类机制。这种增强作用虽然在急性疼痛管理中有利,但可能有一些不良临床意义。