Lizarraga Ignacio, Chambers J Paul, Johnson Craig B
Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, México D.F., C.P. 04510, México.
Anesth Analg. 2008 Dec;107(6):2061-7. doi: 10.1213/ane.0b013e318187ac06.
Nonsteroidal antiinflammatory drugs and N-methyl-D-aspartate (NMDA) receptor antagonists reduce pain hypersensitivity when given by the intrathecal (i.t.) route, but their combined effects have hardly been studied. We assessed the effects of the nonsteroidal antiinflammatory drug ketoprofen and the NMDA receptor channel blocker ketamine, given alone and in combination, on mechanical nociceptive thresholds in sheep implanted with indwelling cervical i.t. catheters.
Sheep were given, by i.t. catheter, ketoprofen (200-3200 microM; 100 microL) and ketamine (25-400 microM; 100 microL) alone or in combination (837.95-3350.78 microM; 100 microL; 0.955:0.045 proportion). They also received NMDA (2 mM; 100 microL) preceded by the highest concentration of ketoprofen and ketamine alone or in combination. Saline solution (0.9%; 100 microL) and xylazine (1.95 mM; 100 microL) were used as negative and positive controls, respectively.
Xylazine significantly increased the area under the nociceptive threshold versus time curve values (AUC) for 30, 60, and 180 min posttreatment. Ketoprofen and ketamine, alone and in combination, produced no significant effect on AUC values. NMDA alone decreased the AUC value for 30 min posttreatment. This pain hypersensitivity was prevented by preadministering ketoprofen and ketamine alone and in combination.
In sheep, i.t. administration of ketoprofen and ketamine, alone or together, produced no hypoalgesia; however, they prevented NMDA-induced mechanical hypersensitivity. Ketoprofen and ketamine may have therapeutic potential in conditions associated with persistent pain.
非甾体抗炎药和N-甲基-D-天冬氨酸(NMDA)受体拮抗剂经鞘内(i.t.)途径给药时可减轻痛觉过敏,但它们的联合作用几乎未被研究过。我们评估了非甾体抗炎药酮洛芬和NMDA受体通道阻滞剂氯胺酮单独及联合给药对植入颈段i.t.留置导管的绵羊机械性伤害感受阈值的影响。
通过i.t.导管给绵羊单独或联合给予酮洛芬(200 - 3200微摩尔/升;100微升)和氯胺酮(25 - 400微摩尔/升;100微升)(837.95 - 3350.78微摩尔/升;100微升;比例为0.955:0.045)。它们还在单独或联合给予最高浓度的酮洛芬和氯胺酮之前接受NMDA(2毫摩尔/升;100微升)。分别使用生理盐水(0.9%;100微升)和赛拉嗪(1.95毫摩尔/升;100微升)作为阴性和阳性对照。
赛拉嗪显著增加了治疗后30、60和180分钟时伤害感受阈值与时间曲线下面积值(AUC)。酮洛芬和氯胺酮单独及联合给药对AUC值均无显著影响。单独给予NMDA会降低治疗后30分钟时的AUC值。单独及联合预先给予酮洛芬和氯胺酮可预防这种痛觉过敏。
在绵羊中,鞘内给予酮洛芬和氯胺酮单独或联合使用均未产生镇痛作用;然而,它们可预防NMDA诱导的机械性痛觉过敏。酮洛芬和氯胺酮在与持续性疼痛相关的病症中可能具有治疗潜力。