Short-term pre- and post-operative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception.
Short-term pre- and post-operative stress prolongs incision-induced pain hypersensitivity without changing basal pain perception.
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DOI：
10.1186/s12990-015-0077-3
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发表时间：
2015-12-02
期刊：
影响因子：
3.3
通讯作者：
Tao YX
中科院分区：
文献类型：
--
作者：
Cao J;Wang PK;Tiwari V;Liang L;Lutz BM;Shieh KR;Zang WD;Kaufman AG;Bekker A;Gao XQ;Tao YX
据报道，慢性应激会增加基础疼痛敏感性和/或加剧现有的持续性疼痛。然而，大多数手术患者在手术前具有正常的生理和心理健康状态，例如正常的疼痛感知，尽管他们在手术前和手术后期间确实经历短期压力。这种短期压力是否会影响术后持续疼痛尚不清楚。在这项研究中，我们表明，手术前或手术后暴露于固定6小时，每天连续三天没有改变基础的机械，热，或冷刺激或峰值水平的切口诱导的超敏反应，这些刺激，但是，固定确实延长了持续时间的切口诱导的超敏反应在雄性和雌性大鼠。这些现象也观察到在手术后暴露于强迫游泳25分钟，每天连续3天。短期应激引起的固定证明了血清皮质酮水平的升高，增加游泳不动性，减少蔗糖消耗。通过鞘内注射选择性糖皮质激素受体拮抗剂RU 38486或双侧肾上腺切除术阻断这种短期应激可显著减弱切口诱导的对机械、热和冷刺激的超敏反应的延长。我们的研究结果表明，短期的压力在术前或术后期间延迟术后疼痛恢复，虽然它不影响基础疼痛的感觉。预防短期压力可能有助于患者从术后疼痛中恢复。
Chronic stress has been reported to increase basal pain sensitivity and/or exacerbate existing persistent pain. However, most surgical patients have normal physiological and psychological health status such as normal pain perception before surgery although they do experience short-term stress during pre- and post-operative periods. Whether or not this short-term stress affects persistent postsurgical pain is unclear. In this study, we showed that pre- or post-surgical exposure to immobilization 6 h daily for three consecutive days did not change basal responses to mechanical, thermal, or cold stimuli or peak levels of incision-induced hypersensitivity to these stimuli; however, immobilization did prolong the duration of incision-induced hypersensitivity in both male and female rats. These phenomena were also observed in post-surgical exposure to forced swimming 25 min daily for 3 consecutive days. Short-term stress induced by immobilization was demonstrated by an elevation in the level of serum corticosterone, an increase in swim immobility, and a decrease in sucrose consumption. Blocking this short-term stress via intrathecal administration of a selective glucocorticoid receptor antagonist, RU38486, or bilateral adrenalectomy significantly attenuated the prolongation of incision-induced hypersensitivity to mechanical, thermal, and cold stimuli. Our results indicate that short-term stress during the pre- or post-operative period delays postoperative pain recovery although it does not affect basal pain perception. Prevention of short-term stress may facilitate patients’ recovery from postoperative pain.