脑源性神经营养因子对大鼠瑞芬太尼麻醉后切口痛的影响

Brain-derived neurotrophic factor in rat incisional pain after remifentanil anesthesia effects

目的观察脑源性神经营养因子（BDNF）对瑞芬太尼麻醉后切口痛大鼠行为的影响，探讨瑞芬太尼诱发痛觉过敏的机制。方法60只sD大鼠术前6d鞘内置管，随机分为5组（n=12）：对照组C组（鞘内注射生理盐水），切口痛I＋Ns组（切口并鞘内注射生理盐水），切口痛I＋BR组（切口并鞘内注射BDNF抗体），瑞芬太尼I＋R＋Ns组（应用瑞芬太尼、切口并鞘内注射生理盐水），瑞芬太尼I＋R＋BR组（应用瑞芬太尼、切口并鞘内注射BDNF抗体）。按照Brennan法行切口模型手术，生理盐水、瑞芬太尼和BDNF抗体均在术中给予。分别于术前24h（基础值），术后24、48h测定机械痛阈。结果与术前24h比较，C组术后机械痛阈值差异无统计学意义（P〉0．05），I＋NS组、I＋BR组、I＋R＋NS组及I＋R＋BR组机械痛阈明显降低（P〈0．05）。术后24h及48h机械痛阈，与C组比较，I＋Ns组、I＋BR组、I＋R＋Ns和I＋R＋BR组机械痛降低（P〈0．05）；与I＋Ns组比较，I＋BR组机械痛阈升高，I＋R＋Ns组和I＋R＋BR组机械痛阈降低（P〈0．05）；与I＋BR组比较，I＋R＋Ns组和I＋R＋BR组机械痛阈降低（P〈0．05）；与I＋R＋NS组比较，I＋R＋BR组机械痛阈升高（P〈0．05）。结论瑞芬太尼可能通过上调切口痛大鼠中枢神经系统BDNF表达而诱导痛觉过敏。

Objective To observe the-brain-derived neurotrophic factor （BDNF） for remifentanil incision pain in rats, to explore the possible mechanism of remifentanil-induced hyperalgesia. Methods 60 SD rats were randomly divided into five groups （n = 12） ： control group C （Intrathecal injection of sa- line）, incision pain group I ＋ NS （Incision and intrathecal injection of saline）, incision pain group I ＋ BR （ Incision and intrathecal BDNF antibody）, remifentanil Group I ＋ R ＋ NS （ Application of remifentanil, in- cision and intrathecal injection of saline） and remifentanil group I ＋ R ＋ BR （ Application of remifentanil, incision and intrathecal injection of BDNF antibody）. 24 h before surgery （baseline）, 24 h and 48 h after surgery, mechanical pain threshold were determinded, respectively. Results Compared with the baseline, postoperative group I ＋ NS, I ＋ BR, I ＋ R ＋ NS, I ＋ R ＋ BR have lower mechanical pain threshold （ P 〈 0. 05）. With the same time after surgey 24 h and 48 h, compared with the group C, I ＋ NS, I ＋ BR, I ＋ R ＋ NS and I ＋ R ＋ BR mechanical pain thresold is lower （P 〈 0.05 ） ; compared with group I ＋ NS, group I ＋ BR mechanical pain threshold is higher, I ＋ R ＋ NS and I ＋ R ＋ BR group mechanical pain threshold is lower（ P 〈 0. 05 ） ; with I ＋ BR group, I ＋ R ＋ NS and I ＋ R ＋ BR group mechanical pain threshold is lower （P 〈 0. 05） ; compared with I ＋ R ＋ NS, I ＋ R ＋ BR mechanical pain threshold is higher （ P 〈 0. 05 ）. Conclusion Remifentanil may increase incision pain in rats by central and peripheral nervous system and BDNF expression induce hyperalgesia.