Department of Anesthesia, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa.
Wound Repair Regen. 2013 Sep-Oct;21(5):730-9. doi: 10.1111/wrr.12081. Epub 2013 Aug 8.
Our previous studies using rat models of incisional pain have shown that tissue lactate levels increase and pH decreases for several days after incision, suggesting the presence of an ischemic-like condition. The purpose of this study was to evaluate the time course and the extent of tissue hypoxia that develops in incised muscle and skin. We directly measured oxygen tension at several time points after incisions of the gastrocnemius muscle, the paraspinal skin, and the plantar hindpaw in anesthetized rats using an oxygen-sensitive microelectrode. In vivo hypoxia of the incised tissues was also evaluated immunohistochemically using a hypoxia marker, pimonidazole hydrochloride. To minimize intersubject variability, unincised contralateral tissues were used as a control. Tissue oxygen tension was decreased in both skeletal muscle and skin compared with control, for several days after incision. When measured directly, oxygen tension decreased immediately and remained low for several days after incisions. Pimonidazole immunostaining revealed hypoxic areas in incised muscle and skin for several days. By postoperative day 10, tissue oxygen tension recovered to that of control tissue. These results support the evidence that a hypoxic condition is present in deep tissue after incisions and that an ischemic-like mechanism may contribute to postoperative pain.
我们之前使用切口疼痛大鼠模型的研究表明,在切口后几天内,组织中的乳酸水平增加,pH 值降低,表明存在类似缺血的情况。本研究旨在评估在切开的肌肉和皮肤中发生的组织缺氧的时间过程和程度。我们使用氧敏微电极在麻醉大鼠的几个时间点直接测量了腓肠肌、脊柱旁皮肤和足底后足切口后的氧分压。还使用缺氧标志物盐酸匹莫硝唑通过免疫组织化学评估了切口组织的体内缺氧情况。为了最小化个体间的变异性,未切开的对侧组织被用作对照。与对照相比,组织氧分压在切口后几天内均降低了。直接测量时,氧分压在切口后立即下降,并持续数天保持低水平。匹莫硝唑免疫染色显示,在切开的肌肉和皮肤中存在缺氧区域数天。到术后第 10 天,组织氧分压恢复到对照组织的水平。这些结果支持了以下证据,即在切口后深部组织中存在缺氧状态,类似缺血的机制可能导致术后疼痛。