低剂量纳洛酮对芬太尼镇痛效应的影响

目的 观察低剂量纳洛酮(naloxone)对芬太尼(fentanvyl)镇痛效应的影响.方法 将试验小鼠80只随机分为两组,分别采用扭体法(40只,雌雄各半)和热板法(40只,均为雌性)观察纳洛酮对芬太尼镇痛小鼠热板法痛阈(HPPT)和扭体次数的影响.各组按分层随机设计分为Fs组(芬太尼与生理盐水合用)及FNl、FN2和FN3组(芬太尼分别与纳洛酮100、10、10ng,1n/kg合用组)四组.结果 与Fs组相比,FN2组HPPT在第5 min增大(P＜0.05);扭体次数FN1和FN2组均显著减少(P＜0.05).结论 纳洛酮在一定剂量范围内能够增强芬太尼的镇痛效应.     

低剂量纳洛酮对氯胺酮镇痛效应的影响

目的 观察低剂量纳洛酮对氯胺酮镇痛效应的影响.方法 100只昆明种小鼠按试验方法的不同平均分为两大组:50只用于热板法试验(雌性),另50只用于扭体法试验(雌雄不拘).各组再随机分为5个小组,即KN组(氯胺酮与生理盐水合用组)及KL1、KL2、KL3、KL4组(氯胺酮分别与纳洛酮1、10、100、1000 ng/kg合用组).分别观察不同剂量纳洛酮对氯胺酮镇痛小鼠热板法痛阈(HPPT)和扭体次数的影响.结果 与KN组相比,KL1和KL2组小鼠HPPT显著增大(P<0.05),同时KL1、KL2和KL3组小鼠扭体次数显著减少(P<0.01).KL4组与KN组相比则无显著差异.结论 低剂量纳洛酮(1～100 ng/kg)能够增强氯胺酮对小鼠的镇痛效应,而1000 ng/kg纳洛酮则无此作用.     

低剂量纳洛酮自身镇痛效应的研究

目的观察低剂量纳洛酮(naloxone)的镇痛效应.方法试验小鼠50只(均为雌性)随机分为生理盐水(NS)组及N1、N2、N3和N4组(纳洛酮1 000、100、10、1 ng/kg)五组,采用热板法观察不同剂量纳洛酮对小鼠热板法痛阈(HPPT)的影响.结果 N1组用药后5、10 min的HPPT值高于其基础HPPT值(P<0.01),N2组用药后5 mill的HPPT值高于其基础HPPT值(P<0.05),但仅N1组用药后5 min的HPPT值显著高于NS组(P<0.01).结论单独使用1～100 ng/kg纳洛酮未见明显的镇痛作用.     

低剂量纳洛酮对布托啡诺镇痛效应的影响

目的 观察低剂量纳洛酮(naloxone)对布托啡诺(butorphanoi)镇痛效应的影响.方法 受试小鼠80只随机分为2组,分别接受扭体法(40只,雌雄各半)和热板法(40只,雌性)试验,观察纳洛酮对布托啡诺镇痛小鼠热板法痛阈(HPPT)和扭体次数的影响.各组再按分层随机设计分为BS组(镇痛剂量布托啡诺与生理盐水合用)、 BN1组、BN2组和BN3组(布托啡诺分别与纳洛酮100、10、1 ng/kg合用).结果 热板法试验提示,与BS组比较,BN2组HPPT在用药后20、30min均增大(P<0.05);扭体法试验提示,与BS组比较,BN2组扭体次数减少(P<0.05).结论 低剂量纳洛酮可增强布托啡诺的镇痛效应,且以纳洛酮10 ng/kg效果最好.     

低剂量纳洛酮对舒芬太尼镇痛效应的影响

目的 观察低剂量纳洛酮对舒芬太尼镇痛效应的影响.方法 试验小鼠80只分为热板法试验组(n=40,均为雌性)和扭体法试验组(n=40,雌雄各半),各组再按分层随机区组设计分为SS组(舒芬太尼与生理盐水合用组)、SN1组、SN2组和SN3组(舒芬太尼分别与低剂量纳洛酮100、10和1 ng/kg合用组),观察低剂量纳洛酮与舒芬太尼合用对小鼠热板法痛阈(HPPT)和扭体次数的影响.结果 与SS组相比,SN3组HTTP值于用药后5和10 min增高(P<0.05),小鼠扭体次数减少(P<0.05).结论 低剂量纳洛酮可增强舒芬太尼的镇痛效应,且以纳洛酮1 ng/kg效果最好.     

低剂量纳洛酮对氯胺酮诱导的小鼠条件性位置偏爱的影响

目的 观察低剂量纳洛酮对氯胺酮诱导的小鼠条件性位置偏爱的影响.方法 受试小鼠40只随机分入氯胺酮与生理盐水组(KS组),氯胺酮与低剂量纳洛酮合用组即KN.组、KN2:组和KN1组(纳洛酮剂量分别为1、10和100 ng/kg),接受条件性位置偏爱(CPP)试验,观察分析受试小鼠用药前后的位置偏爱情况.结果 与KS组相比,低剂量纳洛酮各组白箱停留时间缩短,且KN3组白箱停留时间缩短显著(P<0.05或P<0.01).结论 低剂量纳洛酮可影响氯胺酮诱导的小鼠条件性位置偏爱,提示其有可能减弱氯胺酮的精神依赖性.     

曲马多下肢手术超前镇痛对术后镇痛的影响

目的观察曲马多术前硬膜外注射对于患者人术后止痛效果的影响。方法采用随机、双盲、空白对照的研究方法,择期行下肢手术患者80例,随机分为超前镇痛组(Ⅰ组)和对照组(Ⅱ组)各40例。超前镇痛组术前2h口服胃复安10mg,经硬膜外管注入曲马多1mg/kg,用0.9%NS稀释3ml。对照组注入0.9%生理盐水3ml。观察两组患者术后镇痛药物使用情况、SpO2、血压、心率变化。结果术后疼痛程度采用视觉模拟评分,超前镇痛组和对照组有显著性差异、而且术后恶心、呕吐发生率也明显低于对照组(P<0.05)。结论曲马多超前镇痛能降低下肢手术患者术后镇痛药物使用量,复合口服胃复安能有效减少术后恶心、呕吐发生率。     

氟哌啶醇对曲马多镇痛作用的影响

目的观察氟哌啶醇（haloperidol,HA）对曲马多（TRamadol,TR）镇痛效应的影响,为临床联合用药提供实验依据。方法小鼠分生理盐水NS组,单用TR、HA,HA与TR合用组,用甩尾法和扭体法实验,观察HA对TR镇痛小鼠甩尾潜伏期（tail flick latency,TFL）和扭体次数的影响。结果氟哌啶醇单独用药能提高小鼠对热刺激致痛的痛阈（P〈0．05）,显著减少醋酸致小鼠扭体反应次数（P〈0．01）,氟哌啶醇与曲马多联合应用较两药单用,小鼠的痛阈提高（P〈0．05）、扭体次数明显减少（P〈0．01）。结论氟哌啶醇有镇痛作用,与曲马多合用,镇痛作用增强。     

低剂量吗啡复合曲马多用于胸科手术后镇痛的观察

目的观察低剂量吗啡复合曲马多硬膜外PCA(PCEA)用于胸科手术后镇痛的安全性和有效性。方法行开胸肺叶切除患者48例,年龄45～68岁,术前肺功能检查为基本正常,麻醉分级ASAⅠ～Ⅱ级,随机分两组:A1吗啡复合曲马多组24例,用MT配方(0.004%吗啡、0.5%曲马多、0.004%氟哌利多、0.15%罗呢卡因);A2吗啡组24例,用M配方(0.01%吗啡、0.004%氟哌利多、0.15%罗哌卡因)。麻醉诱导前于T6～7间隙行硬膜外穿刺置管,术中两组都采用静-吸复合麻,术前30min在硬外分别对应给上述药液5mL作负荷量,术毕待患者清醒拔除双腔导管后接持续微量镇痛泵,观察血压、心率、血氧、呼吸频率、疼痛评分、镇静评分、恶心呕吐等情况。结果两组患者术后疼痛评分差别无显著性(P>0.05),镇痛效果均达到优良,术毕12hA2组有2例血氧在89%、90%,经吸氧维持95%以上。结论两组配方用于行胸科术后镇痛效果均确切,与A2组相比,A1组吗啡用量小,更为安全。     

Paradoxical effect of naloxone on nitrous oxide analgesia in man

The effect of naloxone on nitrous oxide analgesia in man has been investigated. The paradoxical response so obtained indicates the possibility of a dural system mediating the pain response in man. These results support previous animal experiments indicating that nitrous oxide analgesia is mediated by the opiate receptors.     

The effect of biogenic amine modifiers on morphine analgesia and its antagonism by naloxone.

The stimulation of dopaminergic receptors, inhibition of serotonin synthesis or blockade of muscarinic receptors by various modifiers led to inhibition of morphine analgesia in mice. Blockade of dopaminergic receptors or the increase in serotonergic or cholinergic activity resulted in the enhancement of morphine analgesia. Serotonergic and cholinergic systems are proposed as positive and the dopaminergic system as negative modulators of morphine analgesia. The modulation of naloxone antagonism was much more complicated than that of morphine analgesia and often the effect of biogenic amine modifiers on antagonism differed from that on analgesia. The fact than biogenic amine modifiers do not affect morphine analgesia and naloxone antagonism by a similar pattern suggests that interaction of narcotics and narcotic antagonists with analgesic receptors may not be exactly the same.     

The effect of stress and adrenalectomy on morphine analgesia and naloxone potency in mice.

Pretreatment of mice with a single injection of corticosterone increased the potency of naloxone in antagonising the antinociceptive effect of morphine measured 3 h later. Pretreatment with morphine also induced a dose-dependent increase in naloxone potency. Co-administration of corticosterone with a low dose of morphine further augmented the potency of naloxone, but in combination with a higher dose of morphine it failed to cause any further potentiation of naloxone potency. Restraint stress for 1 h also caused an increased in naloxone potency when tested 3 h later, and this was further enhanced when tacrine 5.0 mg/kg was administered immediately after stress. Administration of atropine sulphate 2.0 mg/kg s.c. immediately before restraint abolished the effect of stress in potentiating the naloxone potency. Adrenalectomy sensitised mice to the antinociceptive effect of morphine. Although adrenalectomy only partially interfered with the development of increased naloxone potency after pretreatment with morphine, the augmenting effect of tacrine on naloxone potency was completely abolished. Adrenalectomy did not alter the incidence of jumping precipitated by naloxone in morphine-pretreated mice. Both restraint and corticosterone reduced the withdrawal jumping. It is concluded that the stress component of morphine is only partly responsible for the induction of increase in naloxone potency. There is an apparent interaction between central cholinergic mechanisms and stress in the induction of this increased naloxone potency. The phenomenon of increased naloxone antagonism may not be related to the development of acute dependence on morphine.     

低剂量瑞芬太尼在分娩镇痛中对产妇的镇痛效果观察

目的：观察低剂量瑞芬太尼在分娩镇痛中对产妇的镇痛效果。方法：抽选2013年6月～2014年8月在我院分娩的产妇106例,随机分为观察组和对照组,每组53例,对照组产妇给予硬膜外阻滞麻醉,观察组给予低剂量瑞芬太尼镇痛。比较两组产妇给药前后疼痛程度、分娩结局及催产素使用情况。结果：两组产妇给药前疼痛程度比较无显著差异（P>0.05）。观察组给药后各产程疼痛程度与对照组比较均显著较低,总产程与对照组比较显著较短,差异有统计学意义（P<0.05）。两组产妇剖宫产率及催产素使用率比较,差异无统计学意义（P>0.05）。观察组器械助产率与对照组比较显著较少,差异有统计学意义（P<0.05）。结论：低剂量瑞芬太尼用于分娩镇痛对产妇镇痛效果确切,能显著缩短总产程、降低助产器械使用率。     

曲马多与吗啡在术后硬膜外自控镇痛中的效果及不良反应分析

目的探讨曲马多与吗啡在术后硬膜外自控镇痛中的效果及不良反应。方法将本院2009年10月～2012年12月收治的80例需要在术后行硬膜外自控镇痛治疗的患者随机分为对照组和观察组,对照组患者给予吗啡配伍治疗,观察组患者给予曲马多配伍治疗。结果两组患者在镇痛效果上差异无统计学意义（P〉0.05）;观察组不良反应发生率为5.0%,对照组为50.0%,观察组不良反应发生率明显低于对照组（P〈0.05）。结论曲马多配伍用于治疗术后硬膜外自控镇痛的效果比吗啡更显著。