Martin Thomas J, Buechler Nancy L, Eisenach James C
Department of Physiology and Pharmacology, Center for the Study of Pharmacologic Plasticity in the Presence of Pain, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
Anesth Analg. 2006 Sep;103(3):690-5. doi: 10.1213/01.ane.0000226093.46973.39.
Studies of hypersensitivity to mechanical stimuli after incisional surgery suggest that cyclooxygenase (COX)-1, but not COX-2, in the spinal cord participates in postoperative pain. In the current study, we sought to determine the role of COX isoenzymes after laparotomy, examining spontaneous exploratory behavior rather than withdrawal reflexes. Adult male Sprague-Dawley rats underwent subcostal laparotomy surgery under isoflurane anesthesia or received anesthesia without surgery. Exploratory locomotor activity was measured on the first postoperative day after intrathecal injection of dimethyl sulfoxide (vehicle) or COX-1 (SC-560) or COX-2 (NS-398) inhibitors. Laparotomy reduced ambulation, rearing, and rapid small movements (stereotypy) similarly in animals without intrathecal catheters and those receiving intrathecal vehicle control. SC-560 produced a dose-related return to normal exploratory behavior with complete return at doses of 20 mug and larger. In contrast, NS-398 in doses up to 50 mug failed to increase exploratory behavior. These data with exploratory behavior and laparotomy agree with studies with reflexive withdrawal responses after incisional surgery and indicate that COX-1 inhibition reduces pain responses after surgery. Spinal COX-1 inhibition completely restores exploratory activity, including rearing behavior that stretches the abdominal muscles. These data suggest that targeting COX-1 in the spinal cord may produce postoperative analgesia.
关于切开手术后对机械刺激过敏反应的研究表明,脊髓中的环氧化酶(COX)-1而非COX-2参与了术后疼痛。在本研究中,我们旨在确定剖腹手术后COX同工酶的作用,通过检测自发探索行为而非退缩反射来进行研究。成年雄性Sprague-Dawley大鼠在异氟烷麻醉下接受肋下剖腹手术,或接受假麻醉。在鞘内注射二甲基亚砜(赋形剂)或COX-1抑制剂(SC-560)或COX-2抑制剂(NS-398)后的术后第一天测量探索性运动活动。在没有鞘内导管的动物和接受鞘内赋形剂对照的动物中,剖腹手术同样减少了行走、竖毛和快速小幅度运动(刻板行为)。SC-560产生了与剂量相关的探索行为恢复,在剂量为20微克及以上时完全恢复正常。相比之下,高达50微克剂量的NS-398未能增加探索行为。这些关于探索行为和剖腹手术的数据与切开手术后反射性退缩反应的研究结果一致,表明抑制COX-1可减轻术后疼痛反应。脊髓COX-1抑制完全恢复了探索活动,包括伸展腹部肌肉的竖毛行为。这些数据表明,靶向脊髓中的COX-1可能产生术后镇痛作用。