Attal N, Chen Y L, Kayser V, Guilbaud G
INSERM U 161, 75 014 ParisFrance.
Pain. 1991 Oct;47(1):65-70. doi: 10.1016/0304-3959(91)90012-M.
In a model of peripheral mononeuropathy produced by 4 ligatures around the sciatic nerve, we investigated the effects of various i.v. doses of morphine on the vocalization thresholds elicited by paw pressure and compared the effects obtained with the same doses in normal rats. In neuropathic rats, morphine (0.1 and 0.3 mg/kg) produced a significant analgesic effect on the lesioned hind paw, maximum at 15 min post injection with a recovery at 20-25 min. For doses of 0.6 and 1 mg/kg, a modification of the kinetics was observed, with maximum effect at 20-30 min post injection and a recovery at 50-80 min. An analgesic effect was also observed on the unlesioned side, significantly less potent than that observed on the lesioned paw. The effect of 1 mg/kg morphine was almost totally reversed by a 0.1 mg/kg dose of systemic naloxone. The effects induced by the successive doses of morphine on the lesioned paw appeared higher than in normal rats (maximum vocalization thresholds (% of control) following 1 mg/kg morphine (N = 12) were 193.92 +/- 6.57% versus 154 +/- 3.5% in normal rats N = 3), whereas they were comparable to those obtained from the sham-operated paw. The present data clearly show that morphine induces potent antinociceptive effects in a rat model of neuropathy, which seems to contradict the classical view that neuropathic pain is opioid resistant. Some possible pathophysiological mechanisms are discussed.
在通过对坐骨神经进行4次结扎制作的周围性单神经病模型中,我们研究了不同静脉注射剂量的吗啡对 paw 压力引起的发声阈值的影响,并将其与相同剂量在正常大鼠中获得的效果进行比较。在神经性大鼠中,吗啡(0.1和0.3mg/kg)对损伤的后爪产生显著的镇痛作用,注射后15分钟时达到最大效果,20-25分钟时恢复。对于0.6和1mg/kg的剂量,观察到动力学发生改变,注射后20-30分钟时达到最大效果,50-80分钟时恢复。在未损伤侧也观察到镇痛作用,其效力明显低于损伤爪。0.1mg/kg剂量的全身纳洛酮几乎完全逆转了1mg/kg吗啡的作用。连续剂量的吗啡对损伤爪诱导的作用似乎高于正常大鼠(1mg/kg吗啡后最大发声阈值(对照的%)(N = 12)为193.92 +/- 6.57%,而正常大鼠(N = 3)为154 +/- 3.5%),而与假手术爪获得的效果相当。目前的数据清楚地表明,吗啡在神经病大鼠模型中诱导出强大的抗伤害感受作用,这似乎与神经性疼痛对阿片类药物耐药的经典观点相矛盾。讨论了一些可能的病理生理机制。