钠离子通道阻滞剂预防慢性疼痛症状发生的观察

背景慢性痛包括痛觉过敏和痛觉感觉异常,是患者感到难以忍受和临床缺乏治疗手段的一种病理现象.目的探讨神经损伤即刻给予钠离子通道阻滞剂(布比卡因)对慢性痛症状产生的预防作用.设计随机对照观察.单位广州医学院病理教研室.材料实验于2002-07在协和医学院基础研究所生理实验室完成.选用成年SD大鼠57只.方法将慢性压迫性神经损伤(坐骨神经轻度结扎)模型大鼠随机分为对照组(14只)和实验组(43只).实验组在坐骨神经轻度结扎后即刻于神经损伤区周围包埋布比卡因粉剂或腔深齐而对照组不给药.观察两组大鼠在行为学、电生理学和组织形态学上的差异.主要观察指标①两组大鼠行为学实验结果.②两组大鼠电生理结果.③两组大鼠背根神经节荧光染色切片、摄片结果.结果纳入大鼠57只,所有动物均存活到实验结束,均进入结果分析.①行为学测定实验组大鼠始终未出现热痛过敏症状,而对照组大鼠出现了持续的热痛过敏症状.②电生理实验实验组大鼠坐骨神经中枢端的神经纤维自发放电百分数显著低于对照组(6.79%,46 7%).③背根神经节切片荧光染色结果实验组6只大鼠损伤侧L4-5的全部背根神经节切片中看不到明显的交感节后神经纤维芽生,没找到篮状细胞,而在对照组2只大鼠损伤侧L4-5的全部背根神经节切片中可看到明显的交感节后神经纤维芽生,共找到篮状细胞41只.结论神经损伤后即刻在损伤区给予钠离子通道阻滞剂布比卡因可降低损伤神经纤维的异位放电,并抑制损伤侧背根神经节内的交感芽生,通过这两方面的共同作用最终可预防慢性痛症状的发生.

Sodium ion channel blocker in preventing the occurrence of chronic ache symptoms

BACKGROUND: Chronic pain, including hyperalgesia and algesthesia paresthesia, is pathological phenomenons making the patients felt unendurable and lacking of clinical treatments.OBJECTIVE: To discuss the role of sodium ion channel blocker (bupivacaine) that may be administered instantly after neurotrauma and may have role of preventing the occurrence of chronic pain.DESIGN: Randomized and controlled study.SETTING: Pathological Department of Guangzhou Medical College.MATERIALS: This experiment was carried out at Physiological Laboratory in the Foundation Research Institute of Beijing Union Medical College in July 2002. Totally 57 adult SD rats were selected.METHODS: Chronic oppression neurotraumatic models were made on rat by mild ligation of sciatic nerve and randomly divided into control group (n=14) and experimental group (n=43). Rats in the experimental group, but not in control group, were given bupivacaine powder or peptizer embedded around neurotraumatic area instantly after mild ligation of sciatic nerves,Differences in behavior, electrophysiological and histomorphological changes were compared between two groups.dorsal root neuroganglion of two groups.RESULTS: Totally 57 rats enrolled in this study, all animals completed Hot pain allergic symptom could not be observed on rats in experimental group during the whole experimental process, but continuously appeared in discharge percentage of nerve fibers at the central end of experimental rat sciatic nerve was remarkably lower than that of the control group (6.79%Sympathetic postganglion nerve fiber budding was not obvious in the slices of entire L4-5 dorsal root neuroganglion of injury side in 6 experimental rats,and basket-shaped cell could not be observed, but sympathetic postganglion nerve fiber budding was obvious in 2 rats in control groups with altogether 41 basket-shaped cells observed.CONCLUSION: Sodium ion channel blocker administrated instantly after nerve injury can reduce the ectopic discharge of injured nerve fibers, as well as suppress the sympathetic budding in injury side dorsal root ganglion, as the combined result, the occurrence of chronic pain would be prevented.