Department of Anesthesiology, Affiliated Provincial Hospital of Anhui Medical University, Anhui Provincial Hospital, Hefei 230001, China.
Department of PET CT, the 105th Hospital of Chinese People's Liberation Army, Hefei 230001, China.
J Clin Anesth. 2017 Feb;37:123-128. doi: 10.1016/j.jclinane.2016.12.016. Epub 2017 Jan 9.
This study aimed to review research on the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on β-endorphin. NSAIDs are commonly used as anti-inflammatory and analgesic drugs. They are well known for inducing peripheral analgesia by inhibiting cyclooxygenase (COX). However, an increasing number of studies have shown that NSAIDs have an analgesic effect not only in the periphery but also at the center. It means that a central analgesic mechanism of the action of NSAIDs exists besides the peripheral mechanism, and the central mechanism likely involves β-endorphin. β-Endorphin is one of the most prominent endogenous peptides, existing in the hypophysis cerebri and hypothalamus. It plays an irreplaceable role in the central and peripheral analgesia in the human body mainly through three mechanisms including three parts, the spinal cord, the supraspinal cord, and peripheries. β-Endorphin plays an important role in the development of hyperalgesia. However, the specific signal transduction pathways between prostaglandin E or NSAIDs and β-endorphin are still not quite clear. Whether NSAIDs can lead to the increased content of β-endorphin in all patients after any operation needs further investigation. Further studies should determine the optimal dose when NSAIDs and opioid drugs are used together, and also explore the existence of one NSAID that has the potential to replace the traditional opioid drugs and can achieve adequate analgesia.
本研究旨在综述非甾体抗炎药（NSAIDs）对β-内啡肽影响的研究。NSAIDs 是常用的抗炎和镇痛药。它们通过抑制环氧化酶（COX）而产生外周镇痛作用，这是众所周知的。然而，越来越多的研究表明，NSAIDs 不仅在外周而且在中枢具有镇痛作用。这意味着 NSAIDs 的作用除了外周机制外还存在中枢镇痛机制，而该中枢机制可能涉及β-内啡肽。β-内啡肽是最突出的内源性肽之一，存在于脑垂体和下丘脑。它通过脊髓、脊髓以上和外周三个部分的三个机制，在人体的中枢和外周镇痛中发挥着不可替代的作用。β-内啡肽在痛觉过敏的发展中起着重要作用。然而，前列腺素 E 或 NSAIDs 与β-内啡肽之间的确切信号转导途径仍不完全清楚。NSAIDs 是否能导致所有患者在任何手术后β-内啡肽含量增加，仍需进一步研究。进一步的研究应确定 NSAIDs 和阿片类药物联合使用时的最佳剂量，并探讨是否存在一种 NSAID 具有替代传统阿片类药物的潜力，从而实现充分的镇痛效果。
