Department of Anatomy, Federal Medical College Islamabad. Islamabad, Pakistan.
Department of Anatomy, Institute of Basic Medical Science, Khyber Medical University, Peshawar, Pakistan.
Mol Pain. 2024 Jan-Dec;20:17448069241252385. doi: 10.1177/17448069241252385.
Preemptive analgesia is used for postoperative pain management, providing pain relief with few adverse effects. In this study, the effect of a preemptive regime on rat behavior and expression in the spinal cord of the uterine surgical pain model was evaluated. It was a lab-based experimental study in which 60 female Sprague-Dawley rats; eight to 10 weeks old, weighing 150-300 gm were used. The rats were divided into two main groups: (i) superficial pain group (SG) (with skin incision only), (ii) deep pain group (with skin and uterine incisions). Each group was further divided into three subgroups based on the type of preemptive analgesia administered i.e., "tramadol, buprenorphine, and saline subgroups." Pain behavior was evaluated using the "Rat Grimace Scale" (RGS) at 2, 4, 6, 9 and 24 h post-surgery. Additionally, immunohistochemistry was performed on sections from spinal dorsal horn (T12-L2), and its expression was evaluated using optical density and mean cell count 2 hours postoperatively. Significant reduction in the RGS was noted in both the superficial and deep pain groups within the tramadol and buprenorphine subgroups when compared to the saline subgroup ( ≤ .05). There was a significant decrease in expression both in terms of number of positive cells and the optical density across the superficial laminae and lamina X of the spinal dorsal horn in both SD and DG ( ≤ .05). In contrast, the saline group exhibited c-fos expression primarily in laminae I-II and III-IV for both superficial and deep pain groups and lamina X in the deep pain group only ( ≤ .05). Hence, a preemptive regimen results in significant suppression of both superficial and deep components of pain transmission. These findings provide compelling evidence of the analgesic efficacy of preemptive treatment in alleviating pain response associated with uterine surgery.
超前镇痛用于术后疼痛管理,具有较少的不良反应和良好的镇痛效果。本研究评估了超前镇痛方案对大鼠行为和子宫手术疼痛模型脊髓表达的影响。这是一项基于实验室的实验研究,使用了 60 只 8-10 周龄、体重 150-300 克的雌性 Sprague-Dawley 大鼠。将大鼠分为两组:(i)浅层疼痛组(SG)(仅皮肤切口),(ii)深层疼痛组(皮肤和子宫切口)。每组进一步根据给予的超前镇痛类型分为三个亚组,即“曲马多、丁丙诺啡和生理盐水亚组”。术后 2、4、6、9 和 24 小时使用“大鼠面部表情评分量表(RGS)”评估疼痛行为。此外,还对 T12-L2 脊髓背角切片进行免疫组织化学染色,并在术后 2 小时评估其表达的光密度和平均细胞计数。与生理盐水亚组相比,曲马多和丁丙诺啡亚组的浅层和深层疼痛组的 RGS 评分均显著降低(≤0.05)。在浅层和深层疼痛组中,脊髓背角浅层和 X 层的阳性细胞数和光密度均显著降低(≤0.05)。相比之下,生理盐水组在浅层和深层疼痛组的 I-II 和 III-IV 层以及深层疼痛组的 X 层中仅表现出 c-fos 表达(≤0.05)。因此,超前镇痛方案可显著抑制疼痛的浅表和深部成分的传递。这些发现为超前治疗缓解子宫手术相关疼痛反应的镇痛效果提供了有力证据。
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