Sun W Z, Shyu B C, Shieh J Y
Department of Anaesthesiology, National Taiwan University Hospital, Taipei, ROC.
Br J Anaesth. 1996 Jan;76(1):99-105. doi: 10.1093/bja/76.1.99.
In rats injected s.c. with formalin, behavioural correlates of the amount and pattern of Fos-like immunoreactivity (Fos-Ll) (molecular responses to pain) were studied to test if early phase treatment with 75% nitrous oxide or 2% halothane, or both, suppressed subsequent spinal sensitization. Rats were allocated to four treatment groups: (1) 100% oxygen (control, n = 15), (2) 75% nitrous oxide (0.5 MAC, n = 12), (3) 2% halothane (1 MAC, n = 12), and (4) 75% nitrous oxide with 2% halothane (1.5 MAC, n = 18) for 20 min. Each rat then received a s.c. injection of 1% formalin 50 microliters into the left hindpaw and anaesthesia was maintained for another 5 min (early phase). A fifth group of rats receiving fentanyl 100 micrograms kg-1 (n = 12) 10 min before formalin injection were studied simultaneously as a positive control. Rats in all groups were killed 60 min after formalin injection and maximal counts of Fos-Ll labelled neurones in the dorsal horn of the rat spinal cord were compared according to laminar distribution. Formalin-induced behavioural hyperalgesia during the early phase was suppressed completely by fentanyl, 75% nitrous oxide, or 2% halothane, or both. The late phase response was attenuated by all four anaesthetic regimens within 20 min after injection, whereas behavioural scores for the nitrous oxide, halothane, or both, groups were nearly identical to the control 20 min later. Fentanyl suppressed the late phase response until 30 min after formalin injection but failed to reduce it thereafter. The numbers of Fos-Ll labelled neurones for groups given nitrous oxide, or halothane, or both, were identical to the control, whereas numbers for fentanyl were 47.2% less (P < 0.01). The decrease occurred predominantly in the neck of the dorsal horn (44.9% of control, P < 0.01) and also in the nucleus proprius and superficial laminae (54.4% and 56.2% of control, P < 0.05). In summary, we found that nitrous oxide, or halothane, or both, did not suppress subsequent spinal sensitization to noxious stimulation. This result supports the previous hypothesis that inhalation anaesthesia lacks pre-emptive analgesic action. Inhalation anaesthetic agents, unlike fentanyl, suppress the early and late phase response because of anaesthetic but not analgesic effects. Thus, we suggest that measuring the genetic product of c-fos proto-oncogene is a useful adjunct to pharmacological tests whenever behavioural hyperalgesia is questionable or unobtainable.
给大鼠皮下注射福尔马林后,研究了Fos样免疫反应(Fos-Ll)的数量和模式(对疼痛的分子反应)的行为相关性,以测试早期用75%氧化亚氮或2%氟烷或两者进行治疗是否能抑制随后的脊髓致敏。将大鼠分为四个治疗组:(1)100%氧气(对照组,n = 15),(2)75%氧化亚氮(0.5 MAC,n = 12),(3)2%氟烷(1 MAC,n = 12),和(4)75%氧化亚氮与2%氟烷(1.5 MAC,n = 18),持续20分钟。然后,每只大鼠左后爪皮下注射50微升1%福尔马林,并再维持麻醉5分钟(早期阶段)。在福尔马林注射前给予100微克/千克芬太尼的第五组大鼠(n = 12)作为阳性对照同时进行研究。在福尔马林注射后60分钟处死所有组的大鼠,并根据层状分布比较大鼠脊髓背角中Fos-Ll标记神经元的最大计数。芬太尼、75%氧化亚氮、2%氟烷或两者均可完全抑制早期福尔马林诱导的行为性痛觉过敏。在注射后20分钟内,所有四种麻醉方案均使晚期反应减弱,而氧化亚氮、氟烷或两者组的行为评分在20分钟后与对照组几乎相同。芬太尼可抑制晚期反应直至福尔马林注射后30分钟,但此后未能降低该反应。给予氧化亚氮、氟烷或两者组的Fos-Ll标记神经元数量与对照组相同,而芬太尼组的数量减少了47.2%(P < 0.01)。减少主要发生在背角颈部(为对照组的44.9%,P < 0.01)以及固有核和浅层(分别为对照组的54.4%和56.2%,P < 0.05)。总之,我们发现氧化亚氮、氟烷或两者均不能抑制随后对有害刺激的脊髓致敏。这一结果支持了先前的假设,即吸入麻醉缺乏超前镇痛作用。与芬太尼不同,吸入麻醉剂抑制早期和晚期反应是由于麻醉作用而非镇痛作用。因此,我们建议,每当行为性痛觉过敏存在疑问或无法获得时,测量c-fos原癌基因的基因产物是药理学测试的有用辅助手段。