Kontinen V K, Paananen S, Kalso E
Department of Pharmacology and Toxicology, Institute of Biomedicine, University of Helsinki, Finland.
Anesth Analg. 1998 Feb;86(2):355-60. doi: 10.1097/00000539-199802000-00026.
Peripheral nerve injury may lead to neuropathic pain. Alpha2-adrenergic agonists acting in the descending inhibitory tracts of the spinal cord are effective in acute nociceptive, inflammatory, and, possibly, neuropathic pain. We studied the prevention and treatment of neuropathy with the selective alpha2-adrenergic agonist dexmedetomidine in male Sprague-Dawley rats with unilateral peripheral mononeuropathy resulting from tight ligation of the L5 and L6 spinal nerves. Rats with ligation injury developed mechanical and cold allodynia, but not heat hyperalgesia. Dexmedetomidine (120 microg/kg subcutaneously [S.C.] 30 min before the injury) did not attenuate mechanical or cold allodynia. Dexmedetomidine infusions (60 microg/d for 7 days after the injury, or 30 microg/d for 7 days started 14 days after the injury) did not attenuate mechanical or cold allodynia in the ipsilateral paw, but they increased mechanical allodynia during the latter treatment in the paw contralateral to the injury. Atipamezole (1 mg/kg S.C.) induced mechanical and cold allodynia in rats that had not developed allodynia in 14 days after the injury. In conclusion, although alpha2-adrenergic mechanisms are recognized as important in the development of neuropathic pain-like symptoms in this animal model, we found no favorable effect from systemic treatment with dexmedetomidine at tolerable doses.
We studied the prevention and treatment of nerve injury-induced pain with the alpha2-adrenergic agonist dexmedetomidine in an animal model. At tolerable doses, systemic dexmedetomidine neither prevented nor attenuated neuropathic pain behavior.
周围神经损伤可能导致神经性疼痛。作用于脊髓下行抑制通路的α2肾上腺素能激动剂对急性伤害性疼痛、炎症性疼痛以及可能的神经性疼痛有效。我们研究了选择性α2肾上腺素能激动剂右美托咪定对雄性Sprague-Dawley大鼠单侧周围单神经病的预防和治疗作用,该单神经病由L5和L6脊神经紧密结扎引起。结扎损伤的大鼠出现机械性和冷觉异常性疼痛,但无热痛觉过敏。右美托咪定(损伤前30分钟皮下注射120μg/kg)并未减轻机械性或冷觉异常性疼痛。右美托咪定输注(损伤后7天每天60μg,或损伤后14天开始每天30μg,持续7天)并未减轻同侧爪的机械性或冷觉异常性疼痛,但在后一种治疗期间增加了损伤对侧爪的机械性异常性疼痛。阿替美唑(1mg/kg皮下注射)在损伤后14天未出现异常性疼痛的大鼠中诱发了机械性和冷觉异常性疼痛。总之,尽管α2肾上腺素能机制在该动物模型中被认为在神经性疼痛样症状的发展中很重要,但我们发现在可耐受剂量下全身应用右美托咪定没有有益效果。
我们在动物模型中研究了α2肾上腺素能激动剂右美托咪定对神经损伤诱导疼痛的预防和治疗作用。在可耐受剂量下,全身应用右美托咪定既不能预防也不能减轻神经性疼痛行为。