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.     

超前镇痛对小儿心理应激影响的临床研究

对疼痛的恐惧心理，是术前患者最常见的心理特征。小儿更是如此，由于儿童患者认知能力有限，加上对手术疼痛的惧怕，以至患者在术前对手术、麻醉存在不同程度的心理障碍，从而加重机体应激反应，影响治疗效果以及预后，因此对于围手术期的镇痛显得尤为重要。我院对40例儿童患者术前采取超前镇痛治疗，不仅减轻了疼痛本身对机体的影响，同时也降低了患者的心理压力和应激反应过度，减少了麻醉危险性及术后并发症。     

生长抑素及其拮抗剂对小鼠吗啡镇痛的影响(英文)

AIM: To study the effects of somatostatin (SST) andits antagonist cyclo- (7 - aminoheptanoyl- Phe-D-Trp-Lys-Thr [Bzl]) (SSA) on morphine-induced analgesia.METHODS: The pain assays were the hot plate andthe tail flick test. RESULTS: SST or SSA per seadministered intracerebrally at the doses of 0.1 and Img/mouse did not change the pain threshold of miceboth in the hot plate and in the tail flick test.However, at the higher dose (10 mg/mouse), SST andSSA decreased the pain threshold in the tail flick test     

胍丁胺对小鼠和大鼠镇痛及增强吗啡镇痛

AIM: To study the effect of agmatine on pain and morphine analgesia. METHODS: The effect of agmatine on pain was observed in mouse heat radiant tail-flick test, mouse acetic acid writhing test, and rat 4% saline test. Its enhancing effect on analgesia of morphine and clonidine was assessed in rat and mouse heat radiant tail-flick tests. RESULTS: Agmatine did not significantly prolong tail-flick latency of mice, but reduced the number of acetic acid-induced writhing of mice and inhibited writhing responses to saline completely. It potentiated the analgesic effects of morphine and clonidine in dose-dependent manner and decreased the analgesic ED50 of morphine and clonidine by more than 75% in mouse heat radiant tail-flick test. These effects of agmatine were antagonized by idazoxan. CONCLUSION: Agmatine has weak analgesic effects and potentiates morphine and clonidine analgesia by activation of imidazoline receptors.     

硬膜外氯胺酮超前镇痛对术后镇痛的影响

目的观察切皮前应用氯胺酮在硬膜外腔中的超前镇痛作用对术后镇痛的影响。方法选择40例择期产科手术病人,随机分为两组,每组20人,氯胺酮组在手术开始前于硬膜外腔注入氯胺酮30mg,对照组注入生理盐水。两组均行PCEA吗啡镇痛。记录疼痛出现时间,术后4、8、12、16、24小时VAS评分,24小时镇痛药液消耗量及不良反应。结果氯胺酮组术后疼痛出现时间明显延长(P<0.05);术后16小时及24小时两组VAS评分有统计学意义(P<0.05);两组24小时内吗啡消耗量有统计学意义(P<0.05);两组不良反应无明显差异。结论切皮前硬膜外腔应用氯胺酮具有超前镇痛作用,可加强吗啡术后镇痛的效果。     

硬膜外自控镇痛对剖宫产产妇炎性应激的影响观察

目的观察硬膜外自控镇痛对剖宫产产妇炎性应激的影响。方法将2015年12月至2016年6月本院的56例剖宫产产妇根据随机分配的原则进行分组,对照组的28例产妇术后进行常规哌替啶肌内注射镇痛,观察组的28例产妇术后则进行硬膜外自控镇痛,然后检测与比较两组产妇术前与术后1 d、3 d、5 d的炎性应激指标表达水平。结果术前两组产妇的炎性应激指标表达水平均无显著性差异,P均>0.05,而术后1 d、3 d、5 d两组的炎性应激指标均先升后降,且观察组的表达水平低于对照组,P均<0.05,均有显著性差异。结论硬膜外自控镇痛对剖宫产产妇炎性应激控制有着积极的临床影响,因此其在剖宫产产妇中的应用价值较高。     

硬膜外自控镇痛对剖宫产产妇产后炎性应激的影响观察

目的观察硬膜外自控镇痛对剖宫产产妇产后炎性应激的影响情况。方法选取2015年12月至2016年5月期间于本院进行剖宫产的78例产妇为研究对象,将78例产妇随机分为对照组(哌替啶肌注镇痛组)39例和观察组(硬膜外自控镇痛组)39例,然后检测与比较两组产妇产前及产后12 h、24 h的炎性应激指标血清表达水平。结果两组产妇产前的炎性应激指标血清表达水平均无显著性差异,P均>0.05,而产后12 h、24 h观察组的血清表达水平均低于对照组,P均<0.05。结论硬膜外自控镇痛可更为有效地控制剖宫产产妇的产后炎性应激,因此在剖宫产产妇中的应用价值更高。     

氯胺酮对吗啡镇痛作用及其耐受性的影响

氯胺酮（ｋｅｔａｍｉｎｅ，Ｋｅｔ）是唯一具有显著镇痛作用的静脉麻醉药。临床上，可将Ｋｅｔ与吗啡（ｍｏｒｐｈｉｎｅ，Ｍｏｒ）组成复合麻醉，并有人用Ｋｅｔ戒毒取得初步成功〔１〕。本文观察Ｋｅｔ对Ｍｏｒ镇痛作用及其耐受性的影响。１材料与方法１１药物Ｋｅｔ...     

镇痛与高龄患者心理应激的关系

对疼痛的恐惧和对手术的安全性的担忧，是患者术前最常见的心理特征。老年患者更是如此，由于患者多合并其它系统疾病，同时认知能力降低，加上对手术疼痛和手术过程和预后的惧怕与不确定。导致思者在术前对手术、麻醉存在不同程度的心理障碍，从而加重机体应激反应，造成心血管并发症的增加，影响治疗效果及预后。因此对于围手术期的镇痛显得尤为重要。我院对60例70-95岁的高龄患者，术前采取超前镇痛治疗，不仅减轻了疼痛本身对机体的影响，同时也降低了患者的心理压力和应激反应过度，减少了麻醉危险性及术后并发症。     

小鼠化学性迷路切除后的异食癖行为和前庭功能损害

目的建立一种新的、简便、易操作的评价小鼠前庭功能损害的整体动物模型。方法昆明种小鼠分对照组、旋转组、假损伤组和前庭损伤组4组,每组8只。化学性迷路切除由戊巴比妥钠麻醉下双侧鼓室内注射对氨基苯砷酸(arsanilic acid)0.040ml(100mg/ml)造成,恢复3d转入代谢笼单笼饲养。对照小鼠注射等容生理盐水。小鼠每天被放入直径20cm的水平转台,以70r/min变速旋转75s(转15s停5s),连续3d,以及旋转后5d,检测食量、异食高岭土量、接触翻正反射恢复(CRR)时间和露头游泳时间。结果旋转前的3d,对照组、旋转组、假损伤组与前庭损伤组小鼠的食量和异食高岭土量差异无统计学意义。旋转的3d以及旋转后的5d,假损伤组与前庭损伤组小鼠的平均食量在4.36~4.40g,差异无统计学意义。旋转组2和3d异食高岭土量分别增加185%和223%。假损伤组小鼠旋转的3d,平均异食高岭土量则从旋转前的0.12g分别增加到0.29g,0.36g(P<0.01)和0.35g(P<0.01);旋转后1d下降至0.25g(P<0.01),2d为0.17g,3~5d则与前庭损伤组持平。旋转3d和旋转后5d的前庭损伤组小鼠,平均异食高岭土量始终为0.12~0.15g。假损伤组小鼠平均CRR和露头游泳时间分别为3.13和59.4s,而前庭损伤组小鼠分别为36.3和19.1s。结论双侧化学性迷路切除小鼠对被动运动诱发的3种行为反应消失,可作为一种评价药物对前庭损害的行为模型。     

利鲁唑对吗啡镇痛、耐受和依赖作用的影响(英文)

目的　研究利鲁唑对阿片镇痛、耐受及躯体功能的调节。方法　采用冰醋酸扭体 ,5 5℃热板法和热辐射甩尾法观察利鲁唑对小鼠痛阈及吗啡镇痛效应的影响 ;采用小鼠急性和慢性吗啡耐受模型及小鼠吗啡依赖模型 ,观察利鲁唑对吗啡耐受和依赖的作用。结果　单独皮下注射利鲁唑 2 .5～ 10mg·kg- 1在以上 3种模型无镇痛作用 ,然而能剂量依赖性地增强吗啡镇痛效应。利鲁唑 2 .5～ 10mg·kg- 1剂量依赖性地对抗吗啡引起的急性和慢性耐受。在小鼠吗啡依赖模型中 ,利鲁唑 2 .5～ 10mg·kg- 1剂量依赖性地抑制吗啡戒断症状的产生。结论　利鲁唑自身无镇痛作用 ,但能显著增强吗啡镇痛效应 ,并能预防吗啡所引起的耐受和依赖     

Post-natal morphine differentially affects opiate and stress analgesia in adult rats

Alterations in nociceptive reactivity, opiate receptor binding, and other behavioral responses occur in rats exposed to morphine either in utero or post-natally. The present study examined whether post-natal morphine (0, 1 or 20 g, days 1–7) altered analgesia on the tail-flick and jump tests induced by nonopioid-mediated continuous cold-water swims (CCWS), opioid-mediated intermittent cold-water swims (ICWS) or morphine (2.5 and 5.0 mg/kg, SC) in adult male and female rats. Changes in body weight, developmental sings (e.g., eye opening), basal pain thresholds, and both CCWS and ICWS hypothermia were also assessed. Previously-reported gender differences occurred for all forms of analgesia in control rats. Post-natal morphine treatment transiently increased ICWS analgesia and hypothermia, and transiently decreased CCWS analgesia and hypothermia, suggesting that these effects were not specific to pain inhibition. Post-natal morphine treatment significantly increased the magnitude of morphine analgesia on both tests in females, and significantly decreased the magnitude of morphine analgesia on both tests in males, thereby acting to vitiate the observed gender differences in morphine analgesia. Such effects could not be explained by concomitant changes in other measures. These data indicate that post-natal morphine treatment exerts highly selective effects upon specific analgesic responses which are gender sensitive.     

氟比洛芬酯用于高血压患者围术期镇痛对血浆内皮素浓度的影响

目的观察氟比洛芬酯复合吗啡用于高血压患者围术期镇痛对血浆内皮素（endothelin,ET）浓度的影响。方法择期行上腹部手术的高血压患者40例随机分为A组（单纯吗啡组）和B组（氟比洛芬酯复合吗啡组）。A组术毕行吗啡病人自控镇痛（PCA）,B组于术前静脉注射氟比洛芬酯50mg,术后行氟比洛芬酯复合吗啡PCA。比较术后6、12、24、48h两组患者的VAS评分以及病人的总体舒适度,并于同时点采用放射免疫法测定血浆ET浓度。结果术后6、12、24hB组的VAS评分低于A组,各时点患者舒适度评分B组明显高于A组（P〈0．05）。术后6h两组患者的血浆ET浓度均有所升高,术后24、48hB组患者血浆ET值显著低于A组（P〈0．05）。结论围手术期创伤、应激可以引起血浆ET浓度升高;吗啡联合氟比洛芬酯能有效控制术后疼痛,减少高血压患者术后ET释放,有利于高血压患者的预后。     

Monosodium glutamate and analgesia induced by morphine. Test-specific effects

Neonatal administration of monosodium glutamate (MSG) destroyed perikarya in the arcuate nucleus and median eminence, including those that contain met-enkephalin and beta-endorphin and it increased the density of opiate receptors in the midbrain. Treatment with glutamate decreased the analgesic response on the jump test following a 10 mg/kg dose of morphine, yet increased the analgesic response on the hot-plate test following 1 mg/kg dose of morphine. The present study demonstrated that changes in morphine-induced analgesia induced by glutamate varied as functions of the pain test and of gender. While males treated with glutamate displayed attenuated analgesia induced by morphine (2.5-15 mg/kg) on the jump test, jump thresholds of females treated with glutamate were potentiated after a 10 mg/kg dose of morphine and attenuated after a 15 mg/kg dose of morphine, relative to controls. In contrast, analgesia on the hot-plate test was potentiated in animals of both genders treated with glutamate after all doses of morphine. Changes in tolerance to morphine induced by glutamate also depended on the pain test and gender. While the peak analgesic response on the jump test did not occur until the fifth injection of morphine in all rats treated with glutamate, tolerance on the jump test was subsequently retarded in males treated with glutamate and accelerated in glutamate-treated females. Tolerance on the hot-palate test appeared not to be consistently affected by treatment with glutamate. Morphine-induced hyperthermia was initially decreased in rats treated with glutamate, but subsequently decreased in glutamate-treated males and increased in glutamate-treated females.(ABSTRACT TRUNCATED AT 250 WORDS)     

痛稳素碳末端八肽翻转孤啡肽对抗吗啡镇痛的作用

目的　观察痛稳素碳末端八肽在小鼠脑内对孤啡肽对抗吗啡的镇痛作用的影响。方法　固相多肽合成法合成了痛稳素碳末端八肽 ,用辐射热甩尾法测定痛阈 ,观察 (1)小鼠脑室注射 (icv)孤啡肽对吗啡镇痛作用的影响 ;(2 )小鼠脑室注射 (icv)痛稳素碳末端八肽对小鼠基础痛阈的影响 ;(3)小鼠脑室联合注射 (icv)痛稳素碳末端八肽和孤啡肽对吗啡镇痛作用的影响。结果　孤啡肽可对抗吗啡的镇痛作用 ;痛稳素碳末端八肽本身不影响小鼠的基础痛阈 ,但可逆转孤啡肽对抗吗啡的镇痛作用。结论　痛稳素碳末端八肽在脊髓以上水平可以逆转孤啡肽对抗吗啡的镇痛作用     

盐酸羟考酮用于腹腔镜直肠癌根治术患者镇痛效果的观察

目的:探讨盐酸羟考酮注射液对腹腔镜直肠癌根治术患者自控镇痛时的效价和副作用,并与吗啡自控镇痛进行比较.方法:择期行腹腔镜直肠癌根治术患者120例,ASA Ⅰ～Ⅲ级,按照随机数字表法分成羟考酮组(O组)和吗啡组(M组),每组各60例.手术结束前15 min两组分别给予镇痛负荷量,然后接病人自控镇痛泵.手术结束后观察两组视觉模拟评分、镇痛药物用量、不良反应、镇静水平和患者满意度.结果:两组观察时间内静息和运动时VAS评分无显著差异(P＞0.05),O组镇痛后4 h(2.3±0.8)、8 h(2.5±0.7)和12h (3.1±0.8) Ramsay评分显著低于M组(3.8±0.5,3.9±0.7,4.0±0.5)(P＜0.01,P＜0.05).O组48 h累计呕吐发生率(11％)低于M组(20％)(P＜0.05),呼吸抑制发生率低于M组(P＜0.01).两组间患者镇痛满意度无统计学差异(P＞0.05).结论:盐酸羟考酮可有效用于腹腔镜直肠癌根治术自控镇痛,且呼吸抑制和呕吐发生率低,镇痛效果与吗啡相当.     

黄豆苷元对吗啡所致便秘的治疗作用

目的:研究黄豆苷元对吗啡所致便秘的治疗作用以及对吗啡镇痛作用的影响,并深入探讨其可能的作用机制。方法:对小鼠给予吗啡造成便秘模型,以墨汁胶液在小鼠小肠内推进距离占小肠全长百分比为指标,观察黄豆苷元对吗啡所致便秘的影响;采用热板法检测小鼠疼痛耐受时间,判断黄豆苷元对吗啡镇痛效果的影响;采用ELISA测定小鼠肠组织胃动素(MLT)、P-物质(SP)以及生长抑素(SS)水平。结果:黄豆苷元能显著增加吗啡所致便秘小鼠墨汁胶液推进率(P<0.05),而且不影响吗啡的镇痛作用。黄豆苷元升高正常小鼠和吗啡所致便秘小鼠肠组织MLT及SP水平,降低SS水平。结论:黄豆苷元可明显促进胃肠蠕动,缓解吗啡所致便秘,但不影响吗啡的镇痛效果,其作用可能与促进肠道胃动素,P物质的释放,降低肠道生长抑素的水平有关。     

胍丁胺代谢产物腐胺对吗啡镇痛、耐受和依赖的影响

目的观察腐胺对吗啡镇痛、耐受及依赖的影响,探讨腐胺治疗阿片耐受性和依赖性的潜力。方法小鼠醋酸扭体模型和55℃热板法测痛阈;吗啡恒定剂量给药制备耐受模型,55℃热板法测痛阈;吗啡递增剂量给药制备依赖模型,纳洛酮催促观察戒断症状,以胍丁胺(40 mg.kg-1,ig)为阳性对照药,腐胺灌胃给药剂量分别为10,20,40,80 mg.kg-1。结果在小鼠醋酸扭体模型中腐胺具有镇痛作用;而在小鼠55℃热板实验中,腐胺本身无镇痛作用,能较弱地增强吗啡镇痛;腐胺能够减弱吗啡耐受的形成,对已形成的吗啡耐受也有治疗作用;腐胺能够减弱吗啡躯体依赖的形成和表达。结论腐胺和胍丁胺具有相似的生物学活性,具有治疗阿片耐受和依赖的潜力。     

氯诺昔康用于术后患者自控镇痛的临床疗效和安全性

目的:评价非甾体抗炎药氯诺昔康用于妇科全子宫切除术后患者自控镇痛(PCA)的疗效及安全性。方法:60例全身麻醉下行全子宫切除术术后出现中度以上疼痛的患者随机分为氯诺昔康组和吗啡组。患者根据需要启动PCA泵(氯诺昔康0.8mg/次,吗啡1mg/次,锁定时间5min)。由疼痛缓解程度(PAR)、疼痛缓解总和(TOT-PAR)和患者24h镇痛总体效果来评价镇痛效果,同时监测血小板聚集率、肝、肾功能,并观察胃肠道反应等。结果:氯诺昔康组和吗啡组的TOTPAR和镇痛总体印象评分无显著性差异(P>0.05)。吗啡组起效早于氯诺昔康 组。氯诺昔康组的恶心呕吐的发生率明显低于吗啡组。2组血小板聚集率无显著性差异(P>0.05)。结论:氯诺昔康用于妇科全子宫切除术后PCA镇痛,其镇痛效应与吗啡相近,不良反应较少。