Department of Anesthesiology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, People's Republic of China.
Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.
Drug Des Devel Ther. 2022 Apr 26;16:1183-1189. doi: 10.2147/DDDT.S352411. eCollection 2022.
Neuraxial (spinal and epidural) anesthesia is the cornerstone of ensuring the satisfaction rate of painless delivery; however, whether it prolongs the first stage of labor remains controversial. Although current clinical research results tend to be negative, the conclusions are not convincing due to the lack of basic research. This study was conducted to provide a theoretical reference for this controversy through basic research.
A spinal anesthesia model was established by the intrathecal injection of 0.1% ropivacaine in late-pregnant rats (day 22). The cervical resistance test was used to measure the tension of different groups of isolated cervical tissues. Western blotting and cervical tissue cyclic AMP (cAMP) enzyme-linked immunosorbent assay were performed to clarify the possible related mechanisms.
Cervical resistance experiments showed that the intrathecal injection of ropivacaine decreased the cervical resistance, and norepinephrine injection reversed this effect. Western blotting showed that α2A adrenergic receptor (α-AR) levels gradually increased over time in pregnant rats. The cAMP enzyme-linked immunosorbent assay revealed that the intrathecal injection of norepinephrine reversed the increase in cervical tissue cAMP concentration caused by ropivacaine injection.
Ropivacaine relaxes the cervix. Further, α-AR may be involved in the process of cervical contraction.
椎管内(脊髓和硬膜外)麻醉是确保分娩无痛满意度的基石;然而,它是否会延长第一产程仍存在争议。尽管目前的临床研究结果倾向于否定,但由于缺乏基础研究,结论并不令人信服。本研究旨在通过基础研究为这一争议提供理论参考。
通过向孕晚期大鼠(第 22 天)蛛网膜下腔注射 0.1%罗哌卡因建立椎管内麻醉模型。采用颈阻力试验测量不同组分离颈组织的张力。采用 Western blot 和颈组织环磷酸腺苷(cAMP)酶联免疫吸附试验(ELISA)阐明可能的相关机制。
颈阻力实验表明,罗哌卡因蛛网膜下腔注射降低颈阻力,去甲肾上腺素注射逆转了这一作用。Western blot 显示,妊娠大鼠的α2A 肾上腺素能受体(α-AR)水平随时间逐渐升高。cAMP 酶联免疫吸附试验显示,去甲肾上腺素注射逆转了罗哌卡因注射引起的颈组织 cAMP 浓度升高。
罗哌卡因使宫颈松弛。此外,α-AR 可能参与宫颈收缩过程。