Department of Anesthesiology, Second Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Anesthesiology, Third Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Anesthesiology, University of Hong Kong, Hong Kong Special Administrative Region.
Kaohsiung J Med Sci. 2014 Feb;30(2):68-72. doi: 10.1016/j.kjms.2013.10.007. Epub 2013 Dec 8.
Remote intrathecal morphine preconditioning (RMPC) induces cardioprotection via a neural pathway. Intrathecal lidocaine (LID) blocks spinal cord nerve transmission. This study examine whether LID prevents the effects of RMPC. Anesthetized, open chest, male Sprague-Dawley rats were assigned to one of seven treatment groups 3 days after intrathecal catheter placement. Rats from both RMPC and LID groups, respectively, received intrathecal morphine (3 μg/kg) and lidocaine (1%, 10 μL); morphine was administered by three cycles of 5-minute infusions interspersed with 5-minute infusion-free periods. The LID + RMPC group received the combination of LID and RMPC. Intrathecal naloxone methiodide (NM) (20 μg/kg) was administered either 15 minutes before RMPC, or 5 minutes before LID + RMPC. Ischemia and reperfusion injury were then induced by 30 minutes of left coronary artery occlusion, followed by 120 minutes of reperfusion. Infarct size, as a percentage of the area at risk (AAR), was determined by 2,3,5-triphenyltetrazolium staining. The RMPC and LID groups markedly reduced the infarct size (IS) compared with controls. LID prevented the effect of RMPC. NM had no effect on control and LID + RMPC treatments. However, NM pretreatment reversed cardioprotection of RMPC treatment. Intrathecal morphine preconditioning is ineffective in the presence of neuraxial blockade with lidocaine.
远程鞘内吗啡预处理 (RMPC) 通过神经通路诱导心脏保护。鞘内利多卡因 (LID) 阻断脊髓神经传递。本研究旨在探讨 LID 是否可以预防 RMPC 的作用。麻醉开胸雄性 Sprague-Dawley 大鼠在鞘内置管后 3 天被分配到七个治疗组中的一个。分别给予 RMPC 和 LID 组鞘内吗啡（3μg/kg）和利多卡因（1%，10μL）；吗啡通过 5 分钟输注的三个循环给药，每个循环之间间隔 5 分钟的无输注期。LID+RMPC 组接受 LID 和 RMPC 的联合治疗。鞘内纳洛酮甲碘化物（NM）（20μg/kg）在 RMPC 前 15 分钟或 LID+RMPC 前 5 分钟给予。然后通过左冠状动脉闭塞 30 分钟，再进行 120 分钟的再灌注，诱导缺血再灌注损伤。通过 2,3,5-三苯基氯化四氮唑染色确定梗死面积（IS）占危险区域（AAR）的百分比。与对照组相比，RMPC 和 LID 组明显减少了梗死面积（IS）。LID 预防了 RMPC 的作用。NM 对对照和 LID+RMPC 治疗没有影响。然而，NM 预处理逆转了 RMPC 治疗的心脏保护作用。鞘内吗啡预处理在鞘内利多卡因阻断神经通路的情况下无效。
