Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia.
Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia.
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表达阿片类药物的炎症细胞数量增加不会影响关节内吗啡镇痛
DOI：
10.1093/bja/aeh222
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发表时间：
2004
影响因子：
9.8
通讯作者：
Schäfer M
中科院分区：
文献类型：
--
作者：
Likar R;Mousa SA;Philippitsch G;Steinkellner H;Koppert W;Stein C;Schäfer M
背景：局部表达的β-内啡肽（END）和小剂量吗啡都能缓解膝关节炎的疼痛。在这里，我们研究了接受关节镜膝关节手术的患者的滑膜组织中增强的炎症和END表达是否可能改变关节内（i.a.）在IRB批准和知情同意后，患者被随机分配到以下i.a.手术结束时的治疗：I组（n=39），等渗盐水; II组（n=40），盐酸吗啡1 mg; III组（n=48），盐酸吗啡2 mg; IV组（n=39），盐酸吗啡4 mg。术后疼痛强度通过视觉模拟评分（VAS）、至首次要求镇痛的时间和补充性吡硝酰胺消耗量进行评估。对每个患者的滑膜标本进行染色，以确定是否存在炎性细胞和END，并将这些细胞的数量分为低组和高组。组间差异采用χ2、方差分析和方差分析进行统计学处理。随着i.a.剂量的增加，术后吡硝酰胺总消耗量减少，首次要求镇痛的时间显著增加。吗啡组（P<0.05）。这些剂量-反应关系在炎性细胞和含END的滑膜细胞数量低与高的患者之间没有差异（P> 0.05，mancova）。吗啡镇痛不因滑膜组织内炎症和END表达增强而改变。因此，在发炎的滑膜组织内存在END似乎不干扰i.a.吗啡镇痛
Background.Both locally expressed β-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing arthroscopic knee surgery might shift the analgesic dose–response curve of intra-articular (i.a.) morphine.Methods.Following IRB approval and informed consent, patients were randomly assigned to the following i.a. treatments at the end of surgery: group I (n=39), isotonic saline; group II (n=40), 1 mg morphine hydrochloride; group III (n=48), 2 mg morphine hydrochloride; group IV (n=39), 4 mg morphine hydrochloride. Postoperative pain intensity was assessed by the visual analogue scale (VAS), by the time to first analgesic request and by the supplemental piritramide consumption. Synovial specimens from each patient were stained for the presence of inflammatory cells and END and were discriminated into groups with low versus high numbers of these cells. Differences between groups were statistically analyzed by χ2,anovaandmancovawhere appropiate.Results.Patient characteristics and VAS scores did not differ between groups. Total postoperative piritramide consumption decreased and the time to first analgesic request increased significantly with increasing doses of i.a. morphine (P<0.05,anovaand linear regression). These dose–response relationships were not different between patients with low versus high numbers of inflammatory and END-containing synovial cells (P>0.05,mancova).Conclusions.The dose–response relationship of i.a. morphine analgesia is not shifted by enhanced inflammation and END expression within synovial tissue. Thus, the presence of END within inflamed synovial tissue does not seem to interfere with i.a. morphine analgesia.
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DOI：
10.1172/jci118852
发表时间：
1996-08
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
C. Stein;Martina Pflüger;A. Yassouridis;Jürgen Hoelzl;K. Lehrberger;Carmen Welte;A. Hassan
通讯作者：
C. Stein;Martina Pflüger;A. Yassouridis;Jürgen Hoelzl;K. Lehrberger;Carmen Welte;A. Hassan
影响因子：
5.7
作者：
Rudolf Likar;M. Schafer;F. Paulak;Reinhard Sittl;W. Pipam;H. Schalk;D. Geissler;Günther Bernatzky
通讯作者：
Rudolf Likar;M. Schafer;F. Paulak;Reinhard Sittl;W. Pipam;H. Schalk;D. Geissler;Günther Bernatzky
DOI：
10.1124/jpet.103.057257
发表时间：
2004-02-01
影响因子：
3.5
作者：
Shaqura, MA;Zöllner, C;Schäfer, M
通讯作者：
Schäfer, M
影响因子：
15.9
作者：
Cabot, PJ;Carter, L;Stein, C
通讯作者：
Stein, C
外周阿片类镇痛：从实验到临床研究。
DOI：
10.1097/00001503-199910000-00019
发表时间：
1999
期刊：
Current opinion in anaesthesiology
影响因子：
--
作者：
M. Schäfer
通讯作者：
M. Schäfer