地西泮对焦虑、抑郁小鼠体重、痛阈和自主活动的影响

<正>地西泮(diazepam,安定)作为苯二氮类药物常应用于围术期镇痛和镇静,大多数患者存在一定程度的焦虑和抑郁的状况[1,2]。有研究[3]发现以苯二氮类药物为麻醉前用     

不同负荷剂量吗啡对布托啡诺硬膜外术后镇痛效果的影响

目的观察术后不同负荷剂量吗啡对布托啡诺硬膜外镇痛效果的影响。方法择期腹式全子宫切除手术患者120例(ASAⅠ～Ⅱ),随机分成4组,每组30例,吗啡负荷剂量分别为A组:0.5mg,B组:1.0mg,C组:1.5mg,D组:2.0mg。镇痛泵混合液采用0.2罗哌卡因+布托啡诺8mg+托烷司琼10mg+生理盐水至100ml,分别记录各组术后各时点VAS评分及追加按压次数,电子镇痛泵PCA泵中自动记录进药量,并记录不良反应。结果 B、C组VAS评分明显低于A、D组(P<0.05);B、C组用药量量差异无统计学意义(P>0.05);4组患者不良反应发生率差异无统计学意义(P>0.05)。结论布托啡诺行硬膜外镇痛时吗啡负荷剂量为1.0mg、1.5mg的镇痛效果比其负荷剂量为0.5mg、2.0mg时效果好,但不良反应的发生无差别。     

生长抑素及其拮抗剂对小鼠吗啡镇痛的影响

AIM: To study the effects of somatostatin (SST) and its antagonist cyclo-(7-aminoheptanoyl-Phe-D-Trp-Lys-Thr [Bzl]) (SSA) on morphine-induced analgesia. METHODS: The pain assays were the hot plate and the tail flick test. RESULTS: SST or SSA per se administered intracerebrally at the doses of 0.1 and 1 mg/mouse did not change the pain threshold of mice both in the hot plate and in the tail flick test. However, at the higher dose (10 mg/mouse), SST and SSA decreased the pain threshold in the tail flick test only. SST and SSA administered at the dose of 0.1 mg/mouse did not change morphine-induced analgesia. By contrast, SST and SSA at the doses of 1 and 10 mg/mouse reduced morphine analgesia effects both in the hot plate as well as in the tail flick test. CONCLUSION: Our results indicate that SSA as well as SST may be useful in studying pain mechanisms.     

甲氧氯普胺对小鼠吗啡身体依赖性的影响

目的·· :观察甲氧氯普胺对吗啡身体依赖性的影响。方法·· :皮下注射盐酸吗啡建立吗啡依赖小鼠模型,以纳洛酮催促戒断症状。分别在建立吗啡依赖模型前或后给予不同剂量的甲氧氯普胺,观察其预防性给药和急性给药产生的影响。结果·· :甲氧氯普胺急性给药(20 -80mg·kg-1,ip)吗啡依赖小鼠跳跃次数显著减少 ,体重下降加剧 ;预防性给药 (5-20mg·kg-1,ip)小鼠跳跃次数减少 ,但无统计学意义 ,体重下降有显著性改善。结论·· :甲氧氯普胺可缓解吗啡依赖小鼠的部分戒断症状,在一定程度上抑制吗啡身体依赖的形成。     

嘌呤核苷酸对吗啡依赖大鼠痛阈及急性戒断症状的影响

目的:探讨嘌呤核苷酸对吗啡依赖大鼠痛阈及急性戒断症状的影响。方法:将30只♂ Wistar大鼠随机分为对照组、吗啡组和嘌呤核苷酸+吗啡组,于实验d1、3、5、7用电子压痛仪检测大鼠尾压痛阈值,d2、4、6、8进行热甩尾实验检测大鼠抗热痛觉过敏能力,于d8给药后4h观察纳洛酮急性戒断症状。结果:与对照组相比,d1起吗啡组及嘌呤核苷酸+吗啡组大鼠尾压痛阈值增高(P<0.01),d3起嘌呤核苷酸+吗啡组压痛阈值明显高于吗啡组(P<0.01);d2起吗啡组热甩尾潜伏期延长(P<0.05),d6起嘌呤核苷酸+吗啡组热甩尾潜伏期时间长于吗啡组(P<0.05);嘌呤核苷酸+吗啡组戒断症状评分与吗啡组比有显著的统计学差异(P<0.01)。结论:嘌呤核苷酸能够明显增强吗啡的镇痛作用,并减轻吗啡依赖大鼠的戒断症状。     

粉防己碱对小鼠吗啡戒断症状的影响

目的··：研究中药成分的钙拮抗剂粉防己碱（Ｔｅｔ）对小白鼠吗啡戒断症状的影响。方法··：以剂量递增法形成吗啡依赖模型,用纳洛酮催促戒断。结果··：ｓｃ给药,Ｔｅｔ１０ｍｇ·ｋｇ－１抑制“湿狗”样抖动、腹泻、前爪震颤症状;Ｔｅｔ３０ｍｇ·ｋｇ－１抑制打洞、上睑下垂、前爪震颤、体重下降等症状;Ｔｅｔ６０ｍｇ·ｋｇ－１抑制“湿狗”样抖动、打洞、腹泻、前爪震颤、体重下降等症状。３个剂量组的Ｔｅｔ都不影响小鼠的跳跃反应。结论··：Ｔｅｔ能抑制大部分吗啡戒断症状。     

大剂量吗啡用于晚期癌症患者镇痛疗效观察

目的观察大剂量吗啡注射液对重度疼痛的晚期癌症患者的镇痛效果及不良反应。方法对30例晚期癌痛患者给予大剂量吗啡注射液止痛泵维持镇痛治疗,剂量为5mg·h-1~15mg·h-1,随镇痛效果调整用药量。结果显效率为100%,未出现呼吸抑制。结论大剂量吗啡具有安全、镇痛效果稳定等优点,能显著提高患者的生活质量。     

川芎嗪对小鼠吗啡戒断症状的抑制作用

目的：研究川芎嗪对小鼠吗啡戒断症状的影响。方法：以剂量递增法形成吗啡依赖模型,用纳洛酮催促戒断。结果：ｓｃ给药,Ｌｉｇ２０ｍｇ／ｋｇ抑制“湿狗”样抖动,打洞,前爪震颤症状：Ｌｉｇ４０ｍｇ／ｋｇ抑制跳跃、“湿狗”样抖动、上睑下垂,前爪震颤、体重下降等症状。结论：Ｌｉｇ能抑制大部分吗啡戒断症状。     

山莨菪碱对地西泮小鼠催眠和镇痛作用的影响

目的观察山莨菪碱对地西泮催眠和镇痛作用的影响。方法用翻正反射法观察山莨菪碱对地西泮小鼠睡眠时间的影响;用甩尾法实验观察山莨菪碱对地西泮小鼠甩尾潜伏期的影响。结果在翻正反射实验中,山莨菪碱可缩短地西泮小鼠的睡眠时间(P<0.05);在甩尾法实验中,山莨菪碱对地西泮小鼠的甩尾潜伏期无影响(P>0.05),但二者合用有协同镇痛的趋势。结论山莨菪碱可缩短地西泮的睡眠时间;山莨菪碱与地西泮合用有协同镇痛的趋势。     

川芎嗪对小鼠吗啡戒断症状的抑制作用

目的:研究川芎嗪(Lig)对小鼠吗啡戒断症状的影响。方法:以剂量递增法形成吗啡依赖模型,用纳洛酮催促戒断。结果:sc给药,Lig 2 0mg/kg抑制“湿狗”样抖动、打洞、前爪震颤症状;Lig 4 0mg/kg抑制跳跃、“湿狗”样抖动、上睑下垂、前爪震颤、体重下降等症状;Lig 80mg/kg抑制“湿狗”样抖动、打洞、上睑下垂、前爪震颤、体重下降等症状。结论:Lig能抑制大部分吗啡戒断症状。     

Diazepam effects on striatal met-enkephalin levels following long-term pharmacological manipulations

As measured by highly specific radioimmunoassay, long-term treatment of rats for 28 days with benzodiazepines resulted in a significant increase in the striatal met-enkephalin content, which was opposite to the decrease in this area observed after acute administration. Other areas investigated i.e. the hypothalamus, the medulla oblongata/pons and the midbrain, were unchanged after chronic benzodiazepine treatment. Acute diazapam challenge of these animals revealed a considerable degree of tolerance towards the acute drug effect. In rats chronically treated with morphine for 28 days, acute diazepam administration no longer decreased striatal met-enkephalin, in contrast to rats receiving ethanol for the same time, in which the diazepam-induced decrease was potentiated.     

癌症患者的吗啡个体化滴定

目的观察吗啡个体化滴定对晚期癌症患者疼痛的镇痛效果。方法纳入本研究的中、重度癌痛患者124例,接受吗啡即释片的起始剂量为10～20 mg,治疗中根据疼痛缓解程度调整剂量。以疼痛强度（NRS）评分评价镇痛疗效。结果经治疗患者NRS评分由滴定前（4.5±1.2）下降至（1.2±1.6）,治疗前后差异具有统计学意义（P〈0.05）;完全缓解76例,明显缓解32例,中度缓解8例,未缓解8例,疼痛缓解率为93.5%。治疗中观察到的不良反应有：便秘、恶心、头昏、呕吐、嗜睡和排尿困难等,经及时治疗均能克服,未见因不良反应中止治疗者。结论以最大限度减轻患者痛苦为目标的疼痛治疗有益于提高患者的生活质量。癌痛患者接受吗啡即释片个体化滴定治疗,疗效显著,不良反应大多数能耐受,值得探讨。     

骶管预注吗啡用于痔切除术后镇痛的观察

目的 观察骶管内预注吗啡用于痔切除术后镇痛的效果和安全性。方法 选择择期行痔切除手术60例,选用单次骶管阻滞,随机分为3组,每组20例。Ⅰ组：吗啡1.5 mg+1%利多卡因+0.375%罗哌卡因局麻药;Ⅱ组：吗啡2 mg+1%利多卡因+0.375%罗哌卡因局麻药;Ⅲ组：仅用1%利多卡因+0.375%罗哌卡因局麻药,观察3组术后4,8,16,24 h视觉模拟评分(VAS)以及恶心、呕吐、尿潴留、呼吸抑制等不良反应的发生情况。结果 Ⅰ组和Ⅱ组术后4,8,16,24 h VAS评分明显低于Ⅲ组(P<0.05),Ⅱ组VAS评分又低于Ⅰ组;不良反应Ⅰ组和Ⅱ组稍低于Ⅲ组,3组比较无统计学意义(P>0.05)。结论 吗啡2 mg骶管内预注用于痔切除术后镇痛效果确切,患者舒适,不良反应小。     

小剂量吗啡复合罗哌卡因用于硬膜外分娩镇痛的效果

目的 探讨罗哌卡因复合小剂量吗啡用于硬膜外分娩镇痛的效果。方法 100例初产妇随机分为观察组和对照组。观察组50例足月初产妇采用0.1%罗哌卡因复合0.1 mg·mL^-1吗啡硬膜外分娩镇痛;对照组50例采用0.1%罗哌卡因复合4 μg·mL^-1芬太尼分娩镇痛。观察镇痛起效时间、作用维持时间、产程时间、分娩结局、血流动力学参数及镇痛效果,记录不良反应,评估新生儿Apgar评分并采集脐动脉血气分析。结果 观察组镇痛起效时间长于对照组,作用时间明显长于对照组（P<0.05）,2组产妇在镇痛后疼痛数字等级评分（numerical rating scale,NRS）低于镇痛前（P<0.01）。2组产妇产程时间、分娩结局、Bromage评分、新生儿Apgar评分、脐动脉pH值比较均无统计学意义,2组产妇均无严重不良反应。结论 罗哌卡因复合小剂量吗啡硬膜外分娩镇痛起效稍慢、作用持久、效果确切、不影响产程、不增加母婴并发症。     

Effect of Food and Repeated Injections on Serum Diazepam Levels

Abstract: Diazepam 0.3 mg/kg was administered intravenously three times at intervals of 14 days into seven healthy volunteers. Five hours after injection the subjects ingested either 330 ml of mineral water, mineral water in combination with 2 rusks, or 330 ml of fatty milk with an egg hamburger. Diazepam and N- desmethyldiazepam levels were measured in serum samples drawn at 4, 5, 6, 7 and 8 hours after administration of the drug. At the same time the ability to discriminate flickering light was measured, and the feeling of tiredness was recorded. The serum diazepam levels declined regularly as a function of time after mineral water, but both kinds of food significantly elevated the serum diazepam level from the sixth hour onwards. The ability to discriminate flickering light was not modified. Serum N-desmethyldiazepam levels were significantly elevated after the second and third injections as compared with the first injection. Serum diazepam levels were not lowered. The present findings could be explained by an enterohepatic cycle of diazepam, and suggest that diazepam might induce its own metabolism in man.     

Influence of Diazepam on Contingent Negative Variation

Contingent Negative Variation (CNV) is an event-related potential that develops during a simple experimental situation associating a warning and an imperative stimuli. A neurochemical model of CNV has been recently proposed where CNV amplitude and duration are mediated by cholinergic neurons, themselves stimulated by catecholaminergic neurons and inhibited by GABAergic mechanisms. To test this inhibitory influence of GABAergic mechanisms on CNV amplitude, we recorded CNV and spectral analysis in 10 depressed patients before and after 4 weeks of treatment with diazepam (30–45 mg/day) which potentiates GABAergic transmission. The results showed a significant decrease of CNV amplitude after diazepam (from −12·4 μV±8·0 to −4·5 μV±9·8, t=−3·4, p<0·01). This modification did not depend on changes in depressive symptomatology as assessed by the Hamilton depression scale or on changes in the level of arousal, as evaluated by spectral analysis. Therefore, these results support our hypothesis of a specific GABA inhibitory tone in the genesis of CNV. © 1997 by John Wiley & Sons, Ltd.     

芍药苷联合吗啡治疗中晚期癌性疼痛的临床观察

目的：探讨吗啡联用芍药苷对于中晚期癌痛患者中吗啡消耗量及阿片药物相关副作用的影响。方法：筛选徐医附院肿瘤内科2013年10月至2015年3月住院治疗期间需要使用阿片类药物的癌痛患者42例,按照随机原则分为对照组和观察组,对照组给予吗啡控释片缓解疼痛,观察组在给予吗啡控释片同时加服白芍总苷胶囊（0.3 g胶囊含芍药苷104 mg）0.6 g tid。观察7 d内两组患者吗啡控释片的消耗量,同时记录两组患者视觉模拟量表（VAS）痛觉评估评分,以及便秘、瘙痒、尿潴留、嗜睡和呼吸抑制的发生例数。结果：观察组吗啡7 d内消耗量显著少于对照组（P<0.05）,且副作用的发生例数显著少于对照组。两组的镇痛VAS评分没有显著差异。结论：芍药苷可显著减轻癌痛患者吗啡消耗量,减少了吗啡的相关副作用发生。     

硫酸吗啡控释片治疗重度癌痛的个体化用药

癌症患者最令人恐惧的并发症是疼痛,疼痛仍是目前诊断、治疗过程中非常棘手的问题.有效控制癌痛,最大程度提高生活质量,是患者的权利,也是医师的职责.按照世界卫生组织(WHO)三阶梯止痛治疗原则进行癌痛的规范化治疗,目前绝大多数癌性疼痛患者的疼痛可得到较好缓解.