氢吗啡酮复合丙泊酚对大鼠结直肠扩张模型的麻醉效果及机制

Anesthetic Effects and Mechanism of Hydromorphone Combined with Propofol on Colorectal Dilatation Model

目的研究氢吗啡酮复合丙泊酚用于无痛肠镜检查的麻醉效果,并探讨氢吗啡酮产生内脏痛镇痛作用的机制。方法将清洁级雄性SD大鼠随机分成4组:正常组;丙泊酚组;芬太尼复合丙泊酚组;氢吗啡酮复合丙泊酚组。模型大鼠麻醉10 min后,利用充分润滑的气囊,分别进行1次/5 min,每次持续30 s的结直肠扩张。观察记录各组腹壁撤回反射(AWR3)评分,利用ELISA检测肾上腺素,去甲肾上腺素含量,利用Western blot检测MAPK p38表达变化。结果(1)腹腔注射给药10 min后,丙泊酚组的腹壁撤回反射(AWR3)评分数值明显高于芬太尼复合丙泊酚组以及氢吗啡酮复合丙泊酚组(P<0.0001)。3组均在腹腔注射给药15 min后到达AWR3评分数值最低点,腹部给药20 min后,芬太尼复合丙泊酚组以及氢吗啡酮复合丙泊酚组的AWR3评分数值与给药10~15 min时相比虽有上升,但仍维持在较低水平;(2)芬太尼复合丙泊酚组以及氢吗啡酮复合丙泊酚组的肾上腺素含量,去甲肾上腺素含量与丙泊酚组大鼠相比均有明显降低(肾上腺素:P=0.0023,P=0.0002;去甲肾上腺素:P<0.0001);(3)芬太尼复合丙泊酚组以及氢吗啡酮复合丙泊酚组的pp38/p38比值与丙泊酚组大鼠相比均有明显降低(P<0.0001)。结论氢吗啡酮复合丙泊酚能有效抑制p38MAPK的磷酸化,从而缓解疼痛。

Objective To study the anesthetic effect of hydrocodone combined with propofol for painless colonoscopy and to investigate the mechanism of the analgesic effect produced by hydrocodone.Methods Clean grade male SD rats were randomly divided into four groups:normal group;propofol group;fentanyl combined with propofol group;hydromorphone combined with propofol group.After the model was anesthetized for 10 minutes,colorectal dilation was performed using a fully lubricated balloon for once per 5 min,each lasting 30 s.The abdominal wall withdrawal reflex(AWR3)scores of each group were recorded,and epinephrine and norepinephrine content were detected by ELISA.MAPK p38 expression changes were detected by western blot.Results(1)10 minutes after abdominal administration of propofol,the AWR3 scores of the propofol group were significantly higher than those of the fentanyl combined with propofol group and the hydromorphone combined with propofol group(P<0.0001,P<0.0001).The lowest AWR3 scores were reached 15 minutes after abdominal administration in all three groups.20 minutes after abdominal administration,the AWR3 scores in the fentanyl combined with propofol group and the hydromorphone combined with propofol group were higher than those in the 10 and 15 minutes,but remained low.(2)The contents of epinephrine and norepinephrine in the fentanyl combined with propofol group and the hydromorphone combined with propofol group decreased significantly compared with those in the propofol group(epinephrine:P=0.0023,P=0.0002;norepinephrine:P<0.0001,P<0.0001).(3)The p-p38/p38 ratio was significantly reduced in the fentanyl combined with propofol group and the hydromorphone combined with propofol group(P<0.0001,P<0.0001)compared with the propofol group rats.Conclusion Hydromorphone combined with propofol can effectively inhibit the phosphorylation of p38MAPK,thereby relieving pain.