Capsaicin combined with local anesthetics preferentially prolongs sensory/nociceptive block in rat sciatic nerve.
Capsaicin combined with local anesthetics preferentially prolongs sensory/nociceptive block in rat sciatic nerve.
复制标题
辣椒素结合局部麻醉剂优先延长大鼠坐骨神经中的感觉/伤害性阻滞。
DOI：
10.1097/aln.0b013e31818958f7
复制
发表时间：
2008-11
期刊：
影响因子：
8.8
通讯作者：
Wang GK
中科院分区：
文献类型：
--
作者：
Gerner P;Binshtok AM;Wang CF;Hevelone ND;Bean BP;Woolf CJ;Wang GK
瞬时受体电位香草酸1通道整合伤害性刺激，主要由无髓鞘C纤维伤害感受器表达，但不是低阈值机械感受性感觉或运动纤维。最近的一份报告显示，瞬时受体电位香草酸1通道激动剂辣椒素允许利多卡因的亲水性季铵衍生物QX-314选择性地阻滞C纤维而不阻滞运动。作者在大鼠坐骨神经阻滞模型中测试了单独使用或与0.05%辣椒素一起使用两亲性N-甲基阿米替林、阿米替林、布比卡因或利多卡因是否会产生类似的差异性阻滞。用七氟烷麻醉大鼠（n = 8/组），并将0.2 ml药物单独或与辣椒素一起（同时或10分钟后）注射到坐骨切迹中的坐骨神经旁。运动功能评估伸肌姿势推力。通过疼痛性退缩反射和用锯齿状镊子捏外侧跖骨上的皮肤褶皱（皮肤疼痛）引起的发声来评价伤害性感受。N-甲基阿米替林，阿米替林，布比卡因，或利多卡因，随后注射辣椒素10分钟后，每个引起了一个主要的伤害性特异性阻滞。相比之下，除了N-甲基阿米替林外，同时应用每种局部麻醉剂与辣椒素并没有引起临床上显著的差异性阻滞。叔胺局部麻醉剂和它们的季铵衍生物可以引起一个主要的感觉/伤害性感受器的选择性阻滞时，随后注射辣椒素。瞬时受体电位香草酸1通道激动剂和各种局麻药或其季铵衍生物的联合应用是一种有吸引力的策略，以实现持久的差异性阻滞的区域镇痛。
Transient receptor potential vanilloid 1 channels integrate nociceptive stimuli and are predominantly expressed by unmyelinated C-fiber nociceptors, but not low-threshold mechanoreceptive sensory or motor fibers. A recent report showed that the transient receptor potential vanilloid 1 channel agonist capsaicin allows a hydrophilic quaternary ammonium derivative of lidocaine, QX-314, to selectively block C fibers without motor block. The authors tested whether a similar differential block would be produced using amphipathicN-methyl amitriptyline, amitriptyline, bupivacaine, or lidocaine, either alone or together with 0.05% capsaicin, in a rat sciatic nerve block model. Rats (n = 8/group) were anesthetized with sevoflurane, and 0.2 ml of drug was injected either alone or with capsaicin (simultaneously or 10 min later) next to the sciatic nerve in the sciatic notch. Motor function was assessed by the extensor postural thrust. Nociception was evaluated by the nocifensive withdrawal reflex and vocalization evoked by pinch of a skin fold over the lateral metatarsus (cutaneous pain) with a serrated forceps. N-Methyl amitriptyline, amitriptyline, bupivacaine, or lidocaine, followed by injection of capsaicin 10 min later, each elicited a predominantly nociceptive-specific blockade. In comparison, simultaneous application of each local anesthetic with capsaicin did not elicit a clinically significant differential block, with the exception of N-methyl amitriptyline. Both tertiary amine local anesthetics and their quaternary ammonium derivatives can elicit a predominantly sensory/nociceptor selective block when followed by injection of capsaicin. The combined application of transient receptor potential vanilloid 1 channel agonists and various local anesthetics or their quaternary ammonium derivatives is an appealing strategy to achieve a long-lasting differential block in regional analgesia.