Tong Chuanyao, Conklin Dawn R, Liu Baogang, Ririe Douglas G, Eisenach James C
Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1009, USA.
Anesthesiology. 2008 Jun;108(6):1081-6. doi: 10.1097/ALN.0b013e318167afb3.
Efficacy of analgesics varies with the type of pain. Little is known in this regard concerning labor pain, given the ethical barriers to study in humans and the lack of surrogate animal models. To address this, the authors classified and quantified spontaneous behaviors during labor and delivery in rats and examined the effects of a known analgesic, intrathecal morphine.
Pregnant rats were video recorded for 72 h surrounding the time of anticipated labor and delivery. Specific behaviors were identified and classified into general activities, phasic stretching behaviors, and maternal attention activities. Rats received intrathecal infusion of saline or morphine, 0.035-3.5 microg/h, beginning approximately 1 day before delivery, and effects on behaviors and response to noxious heating of the paw were quantified.
Phasic stretching behaviors occurred with high frequency before delivery of the first pup and were rare after delivery of the last pup. Intrathecal morphine at infusion rates greater than 0.035 microg/h abolished these behaviors without affecting general or maternal behaviors or the timing or duration of labor and delivery. Morphine was also antinociceptive to noxious heat, but only at infusion rates of 1.0 microg/h or higher.
Phasic stretching behaviors are observed after distension or inflammation of pelvic viscera in rats, and similar behaviors occur during labor and delivery. Selective and dose-related blockade by intrathecal morphine of only these behaviors suggests that they reflect nociception and that this simple monitoring method can be used to study therapies for the pain of labor and delivery.
镇痛药的疗效因疼痛类型而异。鉴于人体研究存在伦理障碍且缺乏替代动物模型,关于分娩疼痛在这方面所知甚少。为解决这一问题,作者对大鼠分娩期间的自发行为进行了分类和量化,并研究了一种已知镇痛药鞘内注射吗啡的效果。
在预计分娩时间前后72小时对怀孕大鼠进行视频记录。确定特定行为并将其分为一般活动、阶段性伸展行为和母性行为关注活动。从分娩前约1天开始,大鼠接受鞘内注射生理盐水或0.035 - 3.5微克/小时的吗啡,并对行为影响和对爪部有害热刺激的反应进行量化。
在第一只幼崽分娩前,阶段性伸展行为频繁出现,在最后一只幼崽分娩后则很少见。输注速率大于0.035微克/小时的鞘内吗啡消除了这些行为,同时不影响一般行为或母性行为,也不影响分娩的时间或持续时间。吗啡对有害热刺激也有镇痛作用,但仅在输注速率为1.0微克/小时或更高时有效。
在大鼠盆腔脏器扩张或发炎后可观察到阶段性伸展行为,在分娩期间也会出现类似行为。鞘内吗啡仅对这些行为有选择性且与剂量相关的阻断作用,这表明它们反映了伤害感受,并且这种简单的监测方法可用于研究分娩疼痛的治疗方法。