van den Hoogen Nynke J, de Geus Thomas J, Patijn Jacob, Tibboel Dick, Joosten Elbert A
Department of Anaesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, The Netherlands.
Department of Translational Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Pediatr Res. 2021 May;89(7):1681-1686. doi: 10.1038/s41390-020-01353-x. Epub 2021 Jan 27.
Painful procedures in early life cause acute pain and can alter pain processing at a spinal level lasting into adulthood. Current methods of analgesia seem unable to prevent both acute and long-term hypersensitivity associated with neonatal pain. The current study aims to prevent acute and long-term hypersensitivity associated with neonatal procedural pain using methadone analgesia in rat pups.
Sprague-Dawley rat pups received either methadone (1 mg/kg) or saline prior to repetitive needle pricks into the left hind paw from the day of birth (postnatal day (P)0) to P7. Control littermates received a tactile stimulus. Mechanical sensitivity was assessed during the neonatal period (P0-P7), from weaning to adulthood (3-7 weeks) and following surgical re-injury of the same dermatome in adulthood.
Methadone administration completely reversed acute hypersensitivity from P0 to P7. In addition, neonatal methadone analgesia prevented prolonged hypersensitivity after re-injury in adulthood, without affecting sensitivity from weaning to adulthood.
The current study shows that neonatal methadone analgesia can attenuate acute as well as long-term hypersensitivity associated with neonatal procedural pain in a rat model.
Methadone treatment attenuates acute and long-term hypersensitivity associated with neonatal pain in a rat model. Clinical effectiveness studies are urgently warranted to assess acute and long-term analgesic effectivity of methadone.
生命早期的疼痛性操作会引起急性疼痛，并可能改变脊髓水平的疼痛处理过程，这种改变会持续到成年期。目前的镇痛方法似乎无法预防与新生儿疼痛相关的急性和长期超敏反应。本研究旨在使用美沙酮镇痛法预防大鼠幼崽与新生儿程序性疼痛相关的急性和长期超敏反应。
从出生日（出生后第（P）0天）至P7，对Sprague-Dawley大鼠幼崽在反复针刺左后爪之前给予美沙酮（1mg/kg）或生理盐水。对照同窝幼崽接受触觉刺激。在新生儿期（P0 - P7）、从断奶到成年期（3 - 7周）以及成年期同一皮节手术再损伤后评估机械敏感性。
给予美沙酮完全逆转了从P0到P7的急性超敏反应。此外，新生儿美沙酮镇痛可预防成年期再损伤后的长期超敏反应，且不影响从断奶到成年期的敏感性。
本研究表明，在大鼠模型中，新生儿美沙酮镇痛可减轻与新生儿程序性疼痛相关的急性和长期超敏反应。
美沙酮治疗可减轻大鼠模型中与新生儿疼痛相关的急性和长期超敏反应。迫切需要进行临床有效性研究以评估美沙酮的急性和长期镇痛效果。
