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一种妇科手术后的疼痛模型:鞘内注射和全身应用吗啡的效果

A pain model after gynecologic surgery: the effect of intrathecal and systemic morphine.

作者信息

Tong Chuanyao, Conklin Dawn, Eisenach James C

机构信息

Department of Anesthesiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1009, USA.

出版信息

Anesth Analg. 2006 Nov;103(5):1288-93. doi: 10.1213/01.ane.0000244332.10571.4f.

Abstract

BACKGROUND

Despite recent recognition that visceral pain differs from somatic pain in its neurophysiologic basis and treatment modalities, most laboratory studies of postoperative pain use a model of superficial somatic injury, and there is no model of postoperative pain after gynecologic surgery. We describe spontaneous behavior in rats after laparotomy with or without noxious stimulation of the uterus and cervix to more specially address pain after gynecologic surgery.

METHODS

Female Sprague-Dawley rats received inhaled anesthesia only, anesthesia with laparotomy, or laparotomy plus 60 min of tonic distension of the lower uterine segment and cervix, followed by video observation of spontaneous behavior.

RESULTS

Compared with anesthesia alone, laparotomy decreased some spontaneous behaviors (drinking water, grooming, and exploration). Laparotomy plus uterocervical manipulation further decreased these behaviors and increased abnormal behaviors (licking of the lower abdomen and squashing posture of the pelvis to the floor). Intrathecal and systemic morphine restored spontaneous behavior and reduced abnormal behaviors, with minor differences between routes of administration.

CONCLUSIONS

These data suggest that specific behaviors may distinctly reflect somatic and visceral components of postoperative gynecologic pain, and that this model may be used to test novel therapies to relieve pain in this setting.

摘要

背景

尽管最近人们认识到内脏痛在神经生理学基础和治疗方式上与躯体痛不同,但大多数术后疼痛的实验室研究采用的是浅表躯体损伤模型,且尚无妇科手术后疼痛的模型。我们描述了大鼠在开腹手术时伴或不伴有子宫和宫颈的有害刺激后的自发行为,以更专门地研究妇科手术后的疼痛。

方法

雌性斯普拉格-道利大鼠仅接受吸入麻醉、麻醉下开腹手术,或开腹手术加子宫下段和宫颈60分钟的强直性扩张,随后对自发行为进行视频观察。

结果

与单纯麻醉相比,开腹手术减少了一些自发行为(饮水、梳理毛发和探索)。开腹手术加子宫颈操作进一步减少了这些行为,并增加了异常行为(舔舐下腹部和骨盆向地板挤压的姿势)。鞘内注射和全身使用吗啡恢复了自发行为并减少了异常行为,给药途径之间差异较小。

结论

这些数据表明,特定行为可能明显反映妇科术后疼痛的躯体和内脏成分,并且该模型可用于测试缓解该情况下疼痛的新疗法。

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