Sun Jiehao, Lin Hai, He Guodong, Lin Wendong, Yang Jianping
Department of Anesthesiology, 1st Affiliated hospital, Soochow University, 188#, Shizi Street, Gusu District, Suzhou, 215000, China.
Department of Anesthesiology, 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
BMC Anesthesiol. 2017 Feb 21;17(1):30. doi: 10.1186/s12871-017-0325-3.
Remifentanil induced hyperalgesia (RIH) is characterized by stimulation evoked pain including allodynia and thermal hyperalgesia after remifentanil infusion. N-methyl-D-aspartate (NMDA) receptor was reported to be involved in the progress of RIH. We hypothesized that intrathecal MgSO could relieve hyperalgesia after remifentanil infusion via regulating phosphorylation of NMDA receptor NRB subunit activity in this study.
Thirty two rats were randomly allocated into control group, model of RIH group, RIH plus 100ug MgSO group, RIH plus 300ug MgSO group. Mechanical and thermal hyperalgesia were tested at -24 h, 2 h, 6 h, 24 h, 48 h after remifentanil infusion. Following sacrifice of rats after the last behavioral test, we performed the western blot to detect the expression of spinal phosphorylated NMDA receptor NRB subunit (pNRB) in the L-L segments.
Intrathecal MgSO (100, 300 μg) dose-dependently reduced thermal and mechanical hyperalgesia from 2 h to 48 h after remifentanil infusion. Remifentanil infusion remarkably stimulated the expression of pNRB. Nevertheless, the increased amount of pNRB by RIH was dose-dependently suppressed by intrathecal infusion of MgSO in rats.
Remifentanil induced hyperalgesia/allodynia could be ameliorated by Mg-mediated blockade targeting the NRB subunit in NMDA receptors.
瑞芬太尼诱发痛觉过敏(RIH)的特征是在输注瑞芬太尼后出现刺激诱发的疼痛,包括痛觉过敏和热痛觉过敏。据报道,N-甲基-D-天冬氨酸(NMDA)受体参与了RIH的进展。在本研究中,我们假设鞘内注射硫酸镁可通过调节NMDA受体NRB亚基活性的磷酸化来减轻输注瑞芬太尼后的痛觉过敏。
32只大鼠随机分为对照组、RIH模型组、RIH + 100μg硫酸镁组、RIH + 300μg硫酸镁组。在输注瑞芬太尼后的-24小时、2小时、6小时、24小时、48小时测试机械性和热痛觉过敏。在最后一次行为测试后处死大鼠,我们进行蛋白质免疫印迹法检测L-L节段脊髓磷酸化NMDA受体NRB亚基(pNRB)的表达。
鞘内注射硫酸镁(100、300μg)剂量依赖性地减轻了输注瑞芬太尼后2小时至48小时的热痛觉过敏和机械性痛觉过敏。输注瑞芬太尼显著刺激了pNRB的表达。然而,鞘内注射硫酸镁剂量依赖性地抑制了RIH引起的大鼠pNRB增加量。
Mg介导的针对NMDA受体NRB亚基的阻断可改善瑞芬太尼诱发的痛觉过敏/异常性疼痛。