Wang Shanshan, Cui Weihua, Zeng Min, Ren Yi, Han Song, Li Junfa
Department of Anesthesiology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, People's Republic of China,
Department of Neurobiology, Beijing Institute for Neuroscience, Capital Medical University, Beijing, People's Republic of China.
J Pain Res. 2018 Aug 14;11:1521-1529. doi: 10.2147/JPR.S168008. eCollection 2018.
Studies have confirmed that activation of the neurons of primary somatosensory cortex (S1) is involved in the process of remifentanil (Remi)-induced hyperalgesia (RIH), which can be suppressed by lidocaine (Lido). A total intravenous anesthesia model of rats mimicking clinical Remi-based anesthesia was set up to explore the release of amino acid neurotransmitters of S1 cortex in RIH and its inhibition by Lido in this study.
Sprague Dawley rats were randomly divided into the following four groups: propofol (Pro), Remi, Remi combined Lido, and Lido groups. Mechanical hyperalgesia was evaluated by von Frey test; the amino acid neurotransmitters in the microdialysates of S1 area were detected by high-performance liquid chromatography (HPLC)-fluorescence, and conventional protein kinase C (cPKC)γ levels in the whole-cell lysates and membrane lipid rafts (MLRs) were determined by Western blotting.
The von Frey test showed that co-administration of Lido significantly inhibited a Remi-induced decrease in the threshold of the paw withdrawal response in Remi group at 2 h postinfusion. Meanwhile, the Remi-induced increases in both the excitatory and inhibitory amino acid releases in S1 were suppressed by co-administrating Lido within 5 h postinfusion. Western blotting showed that the increased cPKCγ level in the membrane lipid rafts (MLR) induced by Remi was also inhibited by Lido.
The increased release of amino acid neurotransmitters and the translocation of cPKCγ in MLR suggest the activation of S1 neurons, which may be one of the mechanisms underlying RIH. Lido reduces the release of amino acid neurotransmitters in S1 neurons and the translocation of cPKCγ in MLRs after stopping Remi, which may be one of its antihyperalgesic mechanisms.
研究证实,初级躯体感觉皮层(S1)神经元的激活参与了瑞芬太尼(Remi)诱导的痛觉过敏(RIH)过程,利多卡因(Lido)可抑制该过程。本研究建立了模拟临床基于Remi麻醉的大鼠全静脉麻醉模型,以探讨RIH中S1皮层氨基酸神经递质的释放及其被Lido的抑制作用。
将Sprague Dawley大鼠随机分为以下四组:丙泊酚(Pro)组、Remi组、Remi联合Lido组和Lido组。通过von Frey试验评估机械性痛觉过敏;采用高效液相色谱(HPLC)-荧光法检测S1区微透析液中的氨基酸神经递质,采用蛋白质免疫印迹法测定全细胞裂解物和膜脂筏(MLR)中常规蛋白激酶C(cPKC)γ的水平。
von Frey试验显示,输注后2小时,Lido联合用药显著抑制了Remi组中Remi诱导的爪部退缩反应阈值降低。同时,输注后5小时内,Lido联合用药抑制了Remi诱导的S1区兴奋性和抑制性氨基酸释放增加。蛋白质免疫印迹法显示,Lido也抑制了Remi诱导的膜脂筏(MLR)中cPKCγ水平升高。
氨基酸神经递质释放增加和MLR中cPKCγ易位表明S1神经元被激活,这可能是RIH的潜在机制之一。Remi停药后,Lido减少了S1神经元中氨基酸神经递质的释放以及MLR中cPKCγ的易位,这可能是其抗痛觉过敏机制之一。