George Jaiben, Pulickal Sachin Jose, Singh Anurag, Gautam Mayank, Prasoon Pranav, Kumar Rahul, Ray Subrata Basu
From the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.
J Burn Care Res. 2014 Nov-Dec;35(6):e391-8. doi: 10.1097/BCR.0000000000000042.
Opioids like morphine form the mainstay of treatment for moderate to severe burn pain. However, lack of dedicated burn care service and potentially serious side effects of opioids often compromise effective treatment. Newer drugs as well as newer routes of administration of analgesic drugs are long-felt needs in the management of burn pain. Bradykinin is a potent inflammatory mediator present at sites of tissue damage. The present study investigated the analgesic effect of bradykinin type 2 receptor antagonist HOE 140 after direct intrawound administration in rats. Also, whether the analgesic effect was locally mediated was further evaluated. Tissue damage was produced by a surgical incision involving skin, fascia, and muscle. It has been reported that there are minor differences in inflammatory mediators underlying incision-related and burn injury-related pain. HOE 140 (1, 3, or 10 μg/10 μl physiological saline) was administered into the wound by a sterile micropipette. After an interval of 30 seconds, the wound was closed. HOE 140-induced analgesic effect was compared to other experimental groups of rats which did not receive any drug or those which were treated with either saline (vehicle) or water. Postincisional pain was determined by monitoring behavior, allodynia, and thermal hyperalgesia. Analgesic effect was also determined after drug administration in contralateral paw. HOE 140 (1, 3, 10 μg) significantly relieved mechanical allodynia and guarding in comparison with vehicle-treated group. The analgesic effect of HOE 140 was locally mediated. Healing of the wound was normal. In conclusion, the results suggest that bradykinin type 2 receptor antagonists such as HOE 140 could be useful in the treatment of acute inflammatory pain.
像吗啡这样的阿片类药物是中度至重度烧伤疼痛治疗的主要手段。然而,缺乏专门的烧伤护理服务以及阿片类药物潜在的严重副作用常常会影响有效治疗。在烧伤疼痛管理方面,人们长期以来一直需要新型药物以及镇痛药的新型给药途径。缓激肽是一种存在于组织损伤部位的强效炎症介质。本研究调查了缓激肽2型受体拮抗剂HOE 140在大鼠伤口直接给药后的镇痛效果。此外,还进一步评估了镇痛效果是否由局部介导。通过涉及皮肤、筋膜和肌肉的手术切口造成组织损伤。据报道,切口相关疼痛和烧伤相关疼痛所涉及的炎症介质存在细微差异。将HOE 140(1、3或10微克/10微升生理盐水)用无菌微量移液器注入伤口。间隔30秒后,闭合伤口。将HOE 140诱导的镇痛效果与未接受任何药物的其他实验组大鼠或接受生理盐水(赋形剂)或水治疗的大鼠进行比较。通过监测行为、痛觉过敏和热痛觉过敏来确定切口后疼痛。在对侧爪给药后也测定镇痛效果。与赋形剂治疗组相比,HOE 140(1、3、10微克)显著减轻了机械性痛觉过敏和保护性反应。HOE 140的镇痛效果是由局部介导的。伤口愈合正常。总之,结果表明,像HOE 140这样的缓激肽2型受体拮抗剂可能对急性炎症性疼痛的治疗有用。