From the Department of Anesthesiology, Shimane University Faculty of Medicine, Shimane, Japan.
Reg Anesth Pain Med. 2016 Jan-Feb;41(1):69-74. doi: 10.1097/AAP.0000000000000326.
The μ-opioid receptor (MOR) agonist-induced itch is a significant issue associated with analgesic therapies. Research suggested that systemically administered κ-opioid receptor (KOR) agonists inhibit intrathecal morphine-induced itch in primates. However, serious adverse effects induced by systemically administered KOR agonists may restrict their usefulness in humans. We investigated the effects of intrathecal KOR agonists on intrathecal morphine-mediated itch and antinociception in mice.Mice received intrathecal injections of one of the following drugs: morphine (0.1-1.0 nmol), the selective KOR agonist TRK-820 100 pmol, the combination of morphine 0.3 nmol + TRK-820 (10-100 pmol), and 5 μL of saline. One hour after intraperitoneal administration of the selective KOR antagonist nor-binaltorphimine 1.0 μmol, the effect of TRK-820 100 pmol on intrathecal morphine 0.3 nmol-induced scratching was tested. Total numbers of scratches after intrathecal injection were analyzed. After observing scratching behavior, sedation level was evaluated subjectively. Nociceptive threshold was determined by tail immersion test with intrathecal injections of the following agents: morphine (0.1-1.0 nmol), TRK-820 (10-100 pmol), morphine 0.1 nmol + TRK-820 10 pmol, and 5 μL of saline.Intrathecal TRK-820 dose-dependently inhibited intrathecal morphine-induced scratching compared with that in the saline group. Intraperitoneal nor-binaltorphimine completely inhibited the antiscratching effect of intrathecal TRK-820 100 pmol. The combination of morphine 0.3 nmol and TRK-820 did not alter the sedation score compared with that in the morphine 0.3 nmol group. Morphine 0.1 nmol + TRK-820 10 pmol significantly produced greater thermal antinociceptive effects than morphine 0.1 nmol.We demonstrated that intrathecal KOR agonists exert antipruritic effects on intrathecal morphine-induced itch without affecting sedation. The combination of intrathecal morphine and intrathecal KOR agonists produces more potent antinociceptive effects against a thermal stimulus compared with morphine alone.
μ-阿片受体(MOR)激动剂诱导的瘙痒与镇痛治疗密切相关。研究表明,鞘内给予κ-阿片受体(KOR)激动剂可抑制灵长类动物鞘内吗啡诱导的瘙痒。然而,系统给予 KOR 激动剂引起的严重不良反应可能会限制其在人类中的应用。我们研究了鞘内给予 KOR 激动剂对小鼠鞘内吗啡介导的瘙痒和镇痛的影响。
吗啡(0.1-1.0 nmol)、选择性 KOR 激动剂 TRK-820(100 pmol)、吗啡 0.3 nmol+TRK-820(10-100 pmol)组合,以及 5 μL 生理盐水。在腹腔给予选择性 KOR 拮抗剂 nor-binaltorphimine 1.0 μmol 1 小时后,测试 TRK-820 100 pmol 对鞘内吗啡 0.3 nmol 诱导的搔抓的影响。分析鞘内注射后搔抓的总次数。观察搔抓行为后,主观评估镇静水平。通过鞘内注射以下药物的尾部浸入试验测定痛觉阈值:吗啡(0.1-1.0 nmol)、TRK-820(10-100 pmol)、吗啡 0.1 nmol+TRK-820 10 pmol 和 5 μL 生理盐水。
鞘内给予 TRK-820 呈剂量依赖性抑制鞘内吗啡诱导的搔抓,与生理盐水组相比。腹腔内给予 nor-binaltorphimine 完全抑制鞘内 TRK-820 100 pmol 的抗搔抓作用。与吗啡 0.3 nmol 组相比,吗啡 0.3 nmol+TRK-820 组合并未改变镇静评分。吗啡 0.1 nmol+TRK-820 10 pmol 显著产生比吗啡 0.1 nmol 更强的热镇痛作用。
我们证明鞘内给予 KOR 激动剂对鞘内吗啡诱导的瘙痒具有止痒作用,而不影响镇静作用。与单独使用吗啡相比,鞘内给予吗啡和鞘内 KOR 激动剂组合对热刺激产生更强的镇痛作用。