地佐辛复合酮咯酸氨丁三醇超前镇痛对大鼠术后痛阈和炎性反应的影响

目的:探讨地佐辛复合酮咯酸氨丁三醇超前镇痛（preemptive analgesia，PA）对大鼠术后痛阈和炎性反应的影响。方法: 60只SD大鼠随机分为3组：对照组(N组)、超前镇痛组（CZ组）和术后镇痛组（SZ组），每组各20只。采用腹部正中切口，开腹后无菌缝合关腹模型。各组分别在术前（0 h），术后6 、12 、24 h各取5只大鼠，采用BL-420生物机能实验系统测定痛阈后下腔静脉采血分离血清，ELISA法测定：血清肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）和白细胞介素-1β（interleukin-1β，IL-1β）；免疫印迹法检测P物质（substance P，SP）水平。结果: 0 h三组痛阈比较差异无统计学意义（P＞0.05），6、12 h和24 h痛阈N组显著低于CZ组和SZ组（P＜0.01），而CZ组和SZ组比较无统计学差异（P＞0.05）；0 h N组、CZ组和SZ组TNF-α、IL-1β比较差异无统计学意义（P＞0.05），6、12 h和24 h TNF-α、IL-1β N组显著高于CZ组和SZ组（P＜0.01），6 h CZ组和SZ组比较无统计学差异（P＞0.05），12 h和24 h SZ组显著高于CZ组（P＜0.01）。0 h N组、CZ组和SZ组SP比较差异无统计学意义（P＞0.05），6、12 h和24 h SP N组显著高于CZ组和SZ组（P＜0.01），6 h和12 h CZ组和SZ组比较无统计学差异（P＞0.05），24 h SZ组显著高于CZ组（P＜0.01）。结论:地佐辛复合酮咯酸氨丁三醇镇痛效果确切，能够有效抑制术后炎性因子TNF-α、IL-1β和疼痛因子SP浓度的升高，且PA法效果优于术后镇痛。

Effect of preemptive analgesia with dezocine+ketorolac tromethamine complex on postoperative pain thresholds and inflammatory reaction in rats

AIM: To explore the effects of preemptive analgesia with dezocine+ketorolac tromethamine complex on postoperative pain thresholds and inflammatory reactions in rats. METHODS: A total of 60 adult Sprague Dawley rats were randomized into the control group, the preemptive analgesia (CZ) group and the postoperative analgesia (SZ) group, each with 20 rats. The rats were subjected to an abdominal midline incision followed by sterile suturing. In each group, 5 rats were taken, and the pain thresholds were determined at 0, 6, 12 or 24 h after operation, respectively, using BL-420 biological and functional experimental system. Then, blood samples were collected from the inferior vena. After isolation, the expression of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in serum were determined using enzyme-linked immunosorbent assays. The expression of substance P (SP) were observed using western blot analysis. RESULTS:There was no significant difference in the pain threshold, the levels of TNF-α, IL -1β and SP of the three groups at 0 h (P＞0.05). But at 6,12 or 24 h, the pain threshold of N group was significantly lower than that of CZ and SZ group (P＜0.01). The levels of TNF-α and IL -1β of N group were significantly higher than those of CZ and SZ group (P＜0.01) at 6,12 or 24 h, and although the levels of the CZ group and the SZ group did not show significant difference at 6 h (P＞0.05), the levels of SZ group were significantly higher than the CZ group at 12 and 24 h (P＜0.01). The levels of SP of N group were significantly higher than those of CZ and SZ group (P＜0.01) at 6,12 or 24 h, and although the levels of the CZ group and the SZ group did not show significant difference at 6 and 12 h (P＞0.05), the levels of SZ group were significantly higher than the CZ group at 24 h (P＜0.01). CONCLUSION:Dezocine+ketorolac tromethamine inhibited the expression of the inflammatory factor TNF-α, IL -1β, and the pain factor SP after operation, showing a exact analgesic effect. Compared with postoperative application, the preemptive had a better effect.