内源性阿片类的局部镇痛作用
C Stein1, A H Hassan, K Lehrberger
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
Lancet (London, England)
|August 7, 1993
概括
膝关节液中的阿片类可以通过激活局部受体来减轻疼痛. 阻断这些受体会增加手术后的疼痛,这表明新的外围疼痛缓解策略.
科学领域:
- 疼痛研究 疼痛研究
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
背景情况:
- 阿片类药物通过作用于炎症组织中的局部受体来缓解疼痛.
- 在突组织中内源性阿片类的存在和功能尚不清楚.
研究的目的:
- 为了调查内源性阿片类 (β-endorphin,met-enkephalin,dynorphin) 在突组织中的存在.
- 为了确定这些阿片类是否通过关节内阿片类受体抑制疼痛.
- 评估阻断关节内阿片类受体对术后膝关节疼痛的影响.
主要方法:
- 免疫组织化学被用来检测来自8名患有突炎的患者的突样本中的阿片类.
- 接受膝关节关节镜检查的22名患者被随机分配给接受关节内或静脉内纳洛 (阿片类受体阻断剂) 或安慰剂.
- 术后疼痛被评估使用多个尺度和24小时的止痛药消耗.
主要成果:
- 同胞组织样本显示,炎症细胞对β-endorphin和met-enkephalin呈阳性.
- 与静脉内纳洛组相比,接受静脉内纳洛的患者报告疼痛得分显著提高,并消耗更多止痛药.
- 在手术后的前4小时内,关节内纳洛组的疼痛评分显著更高.
结论:
- 内源性阿片类在炎症的突组织中存在.
- 这些可以通过激活关节内阿片类受体来抑制膝盖手术疼痛.
- 这些发现支持疼痛门控制理论,并建议开发外周作用止痛药.
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