Abram S E, Olson E E
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226.
Anesthesiology. 1994 May;80(5):1114-9. doi: 10.1097/00000542-199405000-00020.
Preemptive treatment with a combination of inhalation anesthesia plus intrathecal morphine has been shown to inhibit development of hyperalgesia that follows subcutaneous (SC) formalin injection in rats. Using a similar paradigm, this study sought to determine whether moderate doses of opioids, administered systemically, could inhibit development of a hyperalgesic state.
Flinches per minute were observed 1 and 5 min after formalin injection (phase 1) and at 5-min intervals for the remainder of 1 h (phase 2) for five groups of rats. All animals received isoflurane 1% during and for 6 min after formalin injection. Groups 1 and 2 received SC alfentanil 200 micrograms/kg or normal saline, respectively, before formalin and 0.5 mg/kg naloxone SC 6 min after formalin. Groups 3 and 4 received SC morphine 20 mg/kg or SC normal saline, respectively, before formalin and SC naloxone 0.5 mg/kg plus naltrexone 0.5 mg/kg after formalin. Group 5 received normal saline at both injection times.
Phase 2 activity was nearly identical for the three control groups. Total phase 2 activity for group 1 (alfentanil) was 16% less than control (not significant, P > 0.05). Total phase 2 activity for group 3 (morphine) was almost identical to control.
Administration of 1% isoflurane plus systemic opioids, administered in doses that produce profound analgesia in standard analgesic testing paradigms, do not produce the significant suppression of subsequent hyperalgesia that has been reported with inhalation anesthesia plus intrathecal opioids.
吸入麻醉与鞘内注射吗啡联合进行的预防性治疗已被证明可抑制大鼠皮下注射福尔马林后痛觉过敏的发展。本研究采用类似的模式,试图确定全身给予中等剂量的阿片类药物是否能抑制痛觉过敏状态的发展。
对五组大鼠在福尔马林注射后1分钟和5分钟(第1阶段)以及在接下来的1小时内每隔5分钟观察每分钟的退缩反应(第2阶段)。所有动物在福尔马林注射期间及注射后6分钟接受1%异氟烷。第1组和第2组在福尔马林注射前分别皮下给予200微克/千克阿芬太尼或生理盐水,并在福尔马林注射后6分钟皮下给予0.5毫克/千克纳洛酮。第3组和第4组在福尔马林注射前分别皮下给予20毫克/千克吗啡或皮下生理盐水,并在福尔马林注射后皮下给予0.5毫克/千克纳洛酮加0.5毫克/千克纳曲酮。第5组在两次注射时均给予生理盐水。
三个对照组的第2阶段活动几乎相同。第1组(阿芬太尼)的第2阶段总活动比对照组少16%(无统计学意义,P>0.05)。第3组(吗啡)的第2阶段总活动与对照组几乎相同。
给予1%异氟烷加全身阿片类药物,其剂量在标准镇痛测试模式下可产生深度镇痛,但不会像吸入麻醉加鞘内阿片类药物那样对随后的痛觉过敏产生显著抑制作用。