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[阿米替林和布比卡因对大鼠坐骨神经慢性阻滞治疗神经性疼痛的外周抗痛觉过敏作用及神经毒理学筛查]

[Peripheral anti-hyperalgesic effect and neurotoxicologic screening of amitriptyline and bupivacaine on sciatic nerve blockade chronically on neuropathic pain in rats].

作者信息

Song Li, Xiao Hong, Yang Fan, Yang Bangxiang, Kang Xianhui, Wen Chuanbing, Liu Hui

机构信息

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Jul;23(7):827-31.

Abstract

OBJECTIVE

To investigate whether the peripheral administration of amitriptyline and bupivacaine produces anti-hyperalgesic effect and to screen the neurotoxicological effect on sciatic nerve blockade in a rat model of neuropathic pain.

METHODS

Twenty-four adult male SD rats [weighing (200 +/- 20) g] were made the models of chronic constriction injury (CCI) and randomly divided into 3 groups (n=8) 5 days after operation: group A (amitriptyline), group B (bupivacaine) and group C (normal saline). 0.5 mL 0.5% amitriptyline, 0.5% bupivacaine or normal saline were given in group A, group B, and group C, respectively through implanted cannulas after 5, 7 and 9 days of CCI once a day for successive 3 days. The motor function was measured before administration and 1, 2, 4, 8, 12 and 24 hours after every administration. Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured before administration and 1, 3, 5 and 7 days after the third administration. The operated sciatic nerve samples were obtained for neuropathological examination under light microscope.

RESULTS

Twenty-four CCI rats were all survival without infection, palsy and catheter falling off. Compared with group C, the rats of group A and group B both produced significant ambulation deficits after every administration (P < 0.05). The ambulation deficits lasted 2 hours (group B) and 8 hours (group A) respectively. But the ambulation deficits of CCI rats were all reversible. The MWT and TWL of group A 1 and 3 days after the third administration increased when compared with those before administration and 5 and 7 days after the third administration, and when compared with group B and group C (P < 0.05). There was no significant difference (P > 0.05) in light microscopic neuropathological examination among three groups. Epineurial tissue and endoneurium tissue integrity, tidy arrangement of fibers, less inflammatory cell and no marked degeneration of myelinated fibers were observed.

CONCLUSION

Repeated sciatic nerve blockade with 0.5% amitriptyline has peripheral anti-hyperalgesic effects on neuropathic pain of rats. No morphological evidence of neurotoxicity in the sciatic nerve of rats is observed in 0.5% amitriptyline.

摘要

目的

研究阿米替林和布比卡因外周给药是否产生抗痛觉过敏作用,并筛选其对神经性疼痛大鼠模型坐骨神经阻滞的神经毒理学效应。

方法

24只成年雄性SD大鼠[体重(200±20)g]制作慢性压迫性损伤(CCI)模型,术后5天随机分为3组(n = 8):A组(阿米替林)、B组(布比卡因)和C组(生理盐水)。CCI术后5、7和9天,分别通过植入套管给予A组0.5 mL 0.5%阿米替林、B组0.5%布比卡因或C组生理盐水,每天1次,连续3天。给药前及每次给药后1、2、4、8、12和24小时测量运动功能。给药前及第三次给药后1、3、5和7天测量机械缩足阈值(MWT)和热缩足潜伏期(TWL)。取手术侧坐骨神经样本进行光镜下神经病理学检查。

结果

24只CCI大鼠均存活,无感染、麻痹及导管脱落。与C组相比,A组和B组大鼠每次给药后均出现明显的行走功能障碍(P < 0.05)。行走功能障碍分别持续2小时(B组)和8小时(A组)。但CCI大鼠的行走功能障碍均为可逆性。第三次给药后1和3天,A组的MWT和TWL较给药前及第三次给药后5和7天升高,且与B组和C组相比升高(P < 0.05)。三组光镜下神经病理学检查无显著差异(P > 0.05)。可见神经外膜组织和神经内膜组织完整,纤维排列整齐,炎症细胞较少,有髓纤维无明显变性。

结论

0.5%阿米替林反复坐骨神经阻滞对大鼠神经性疼痛有外周抗痛觉过敏作用。0.5%阿米替林未观察到大鼠坐骨神经神经毒性的形态学证据。

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