CAJ | 학술논문

目的评价鞘内注射小剂量纳洛酮、吗啡和芬太尼对切口痛大鼠脊髓胃动素(MTL)表达的影响.方法健康雄性SD大鼠72只,体重180 ～ 220 g,采用随机数字表法,将其分为6组(n=12):生理盐水组(NS组)、吗啡+芬太尼组(MF组)、切口痛组(P组)、纳洛酮+切口痛组(NP组)、吗啡+芬太尼+切口痛组(MFP组)、吗啡+芬太尼+纳洛酮+切口痛组(MFNP组).于右足跖肌切口制备切口痛模型,制备切口痛模型前20 min时MF组、MFP组和MFNP组鞘内注射吗啡5 μg/kg+芬太尼0.25 g/kg混合液,NP组和MFNP组给予纳洛酮1 ng/kg.各组取6只大鼠,分别于鞘内置管前(T0,基础状态)、造模前24h(T1)、术后1、3、6 h(T2-4)时测定机械缩足反应阈(PWMT)与热缩足反应潜伏期(PWTL).各组另取6只大鼠,于术后6h时取脊髓、胃体和二十指肠,采用ELISA法检测MTL含量.结果与To时比较,MF组T3时PWMT升高,T22-4时PWTL延长,P组T22-4时PWMT降低,PWTL缩短,NP组T3,4时PWMT降低,PWTL缩短,MFP组T2,3时PWMT升高,MFNP组T2时PWMT升高,PWTL延长(P＜0.05);与NS组比较,MF组和NP组脊髓和胃体MTL含量降低,MF组十二指肠MTL含量降低,NP组十二指肠MTL含量升高,P组和MFP组脊髓MTL含量升高,胃体MTL含量降低,P组十二指肠MTL含量升高,MFP组十二指肠MTL含量降低(P＜0.05),MFNP组上述指标差异无统计学意义(P＞0.05).结论鞘内注射小剂量纳洛酮与吗啡和芬太尼联合应用可抑制切口痛大鼠脊髓MTL表达上调,进而参与维持胃肠动力的稳定.
목적 평개초내주사소제량납락동、마배화분태니대절구통대서척수위동소(MTL)표체적영향.방법 건강웅성SD대서72지,체중180 ～ 220 g,채용수궤수자표법,장기분위6조(n=12):생리염수조(NS조)、마배+분태니조(MF조)、절구통조(P조)、납락동+절구통조(NP조)、마배+분태니+절구통조(MFP조)、마배+분태니+납락동+절구통조(MFNP조).우우족척기절구제비절구통모형,제비절구통모형전20 min시MF조、MFP조화MFNP조초내주사마배5 μg/kg+분태니0.25 g/kg혼합액,NP조화MFNP조급여납락동1 ng/kg.각조취6지대서,분별우초내치관전(T0,기출상태)、조모전24h(T1)、술후1、3、6 h(T2-4)시측정궤계축족반응역(PWMT)여열축족반응잠복기(PWTL).각조령취6지대서,우술후6h시취척수、위체화이십지장,채용ELISA법검측MTL함량.결과 여To시비교,MF조T3시PWMT승고,T22-4시PWTL연장,P조T22-4시PWMT강저,PWTL축단,NP조T3,4시PWMT강저,PWTL축단,MFP조T2,3시PWMT승고,MFNP조T2시PWMT승고,PWTL연장(P＜0.05);여NS조비교,MF조화NP조척수화위체MTL함량강저,MF조십이지장MTL함량강저,NP조십이지장MTL함량승고,P조화MFP조척수MTL함량승고,위체MTL함량강저,P조십이지장MTL함량승고,MFP조십이지장MTL함량강저(P＜0.05),MFNP조상술지표차이무통계학의의(P＞0.05).결론 초내주사소제량납락동여마배화분태니연합응용가억제절구통대서척수MTL표체상조,진이삼여유지위장동력적은정.
Objective To evaluate the effects of intrathecal low-dose naloxone,morphine and fentanyl on the expression of motilin (MTL) in the spinal cord in rats with incisional pain.Methods Seventy-two healthy male Sprague-Dawley rats,weighing 180-220 g,in which intrathecal catheters were successfully implanted,were randomly divided into 6 groups (n =12 each) using a random number table:normal saline group (NS group),morphine + fentanyl group (MF group),incisional pain group (P group),naloxone + incisional pain group (NP group),morphine + fentanyl + incisional pain group (MFP group),and morphine + fentanyl + naloxone +incisional pain group (MFNP group).Incisional pain was induced by an incision made into the plantar surface of the right hindpaw.At 20 min before induction of incisional pain,the mixture of morphine 5 μg/kg and fentanyl 0.25 μg/kg was injected intrathecally in MF,MFP and MFNP groups,and naloxone 1 ng/kg was given in NP and MFNP groups.Six rats from each group were randomly chosen,and paw withdrawal threshold to mechanical stimulation (PWMT) and paw withdrawal latency to thermal stimuli (PWTL) were measured before intrathecal catheterization (T0,baseline),at 24 h before induction of incisional pain (T1),and at 1,3 and 6 h after induction of incisional pain (T2-4).The left 6 rats from each group were chosen and sacrificed and the spinal cord were removed at 6 h after operation for detection of MTL content in the spinal cord,body of the stomach and duodeum tissues (by ELISA).Results Compared with the baseline value at T0,PWMT was significantly increased at T3,and PWTL was prolonged at T2-4 in MF group,PWMT was decreased and PWTL was shortened at T2-4 in P group and at T3,4 in NP group,PWMT was increased at T2,3 in MFP group,and PWMT was increased and PWTL was prolonged at T2 in MFNP group (P ＜ 0.05).Compared with NS group,MTL contents in spinal cord and body of the stomach were significantly decreased in MF and NP groups,MTL cortent in duodeum was decreased in group MF,while increased in group NP and MTL content in spinal cord was increased,and MTL content in body of the stomach was decreased in P and MFP groups,MTL content in duodeum was increased in group P,while decreased in group MFP(P ＜ 0.05),however,no significant change was found in MTL content in MFNP group (P ＞ 0.05).Conclusion Intrathecal low-dose naloxone combined with morphine and fentanyl can inhibit up-regulation of the expression of MTL in the spinal cord in rats with incisional pain and is involved in the maintenance of stable gastrointestinal motility.