Zhang Yinglei, Du Yu, Jiang Yongxiang, Zhu Xiangjia, Lu Yi
Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China.
Front Pharmacol. 2018 Jul 17;9:783. doi: 10.3389/fphar.2018.00783. eCollection 2018.
The aim of our present study is to evaluate the efficacy of pranoprofen eye drops as pain relief during sequential second-eye cataract surgery and to investigate the possible mechanism. Seventy-six patients scheduled for bilateral sequential cataract surgery were randomly assigned to two groups: (1) treatment group (administered pranoprofen eye drops), or (2) control group (administered artificial tears). Preoperative anxiety and intraoperative pain were assessed. Monocyte chemoattractant protein 1 (MCP-1) in the aqueous humor was measured with a suspension cytokine array. An extracapsular lens extraction model was established in the Wistar rat and the MCP-1 concentrations were measured with an enzyme-linked immunosorbent assay. We found that in the control group, the pain scores were significantly higher during second-eye surgery than during first-eye surgery (both scores < 0.001). In the treatment group, there was no significant difference in the pain scores during first-eye and second-eye surgery (both scores > 0.1). The pain during second-eye surgery was significantly lower in the treatment group than in the control group (both scores < 0.01). And in the 1-week and 6-week interval subgroups, the pain scores during second-eye surgery were significantly lower in the treatment group than the control group ( = 0.047 and = 0.035, respectively). While the second-eye MCP-1 level was significantly lower after a 1-week interval in the treatment group than in the control group ( = 0.012), but did not differ significantly after a 6-week interval ( > 0.1). A parallel trend in the MCP-1 concentration was detected in the rat model. In conclusion, the preoperative administration of pranoprofen eye drops reduced the perceived pain during second-eye cataract surgery, especially when performed after 1-week and 6-week intervals between the first-eye and second-eye surgery. MCP-1, a pain-related cytokine, was associated with the pain-relief mechanism of pranoprofen when second-eye surgery was performed 1 week after second-eye surgery.
我们当前研究的目的是评估普拉洛芬滴眼液在二期白内障手术中缓解疼痛的疗效，并探究其可能的机制。76例计划行双眼分期白内障手术的患者被随机分为两组：（1）治疗组（给予普拉洛芬滴眼液），或（2）对照组（给予人工泪液）。评估术前焦虑和术中疼痛情况。采用悬浮细胞因子阵列检测房水中单核细胞趋化蛋白1（MCP-1）。在Wistar大鼠中建立囊外晶状体摘除模型，并用酶联免疫吸附测定法测量MCP-1浓度。我们发现，在对照组中，二期手术时的疼痛评分显著高于一期手术（P值均<0.001）。在治疗组中，一期和二期手术时的疼痛评分无显著差异（P值均>0.1）。治疗组二期手术时的疼痛明显低于对照组（P值均<0.01）。并且在间隔1周和6周的亚组中，治疗组二期手术时的疼痛评分显著低于对照组（分别为P = 0.047和P = 0.035）。虽然治疗组间隔1周后二期手术时MCP-1水平显著低于对照组（P = 0.012），但间隔6周后无显著差异（P>0.1）。在大鼠模型中检测到MCP-1浓度呈平行趋势。总之，术前给予普拉洛芬滴眼液可减轻二期白内障手术时的疼痛感知，尤其是在一期和二期手术间隔1周和6周进行时。MCP-1，一种与疼痛相关的细胞因子，在二期手术1周后进行二期手术时与普拉洛芬的镇痛机制有关。
