Deleterious impact of a γ-aminobutyric acid type A receptor preferring general anesthetic when used in the presence of persistent inflammation.
Deleterious impact of a γ-aminobutyric acid type A receptor preferring general anesthetic when used in the presence of persistent inflammation.
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DOI：
10.1097/aln.0b013e318215e1cb
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发表时间：
2011-10
期刊：
影响因子：
8.8
通讯作者：
Gold MS
中科院分区：
文献类型：
--
作者：
Boegel K;Gyulai FE;Moore KK;Gold MS
实验数据表明，γ-氨基丁酸-A受体偏好全身麻醉药（GA）可能会增加持续性炎症（PI）患者的术后疼痛。本研究旨在开始检验这一预测。通过炎症的存在、手术干预和/或用于三小时麻醉期的GA的类型来定义大鼠组。用完全弗氏佐剂诱导PI。手术干预是足底切口。使用了三种机制不同的GA：戊巴比妥、氯胺酮/甲苯噻嗪和异氟烷。持续的疼痛和超敏反应进行了评估与守卫行为分析和冯弗雷试验，分别。在没有PI的情况下，GA类型对术后超敏反应恢复的幅度或时间过程没有影响。然而，在存在PI的情况下，戊巴比妥组从超敏反应中的恢复显著慢于氯胺酮/甲苯噻嗪或异氟烷组。戊巴比妥效应在手术后3天内显著，并持续到试验期的剩余时间。在未进行后爪切口的戊巴比妥麻醉的发炎大鼠中观察到相当的恢复延迟。在戊巴比妥治疗的炎症组中，至50%恢复的时间几乎是其他组的两倍。氯胺酮/甲苯噻嗪和异氟烷之间未观察到差异。戊巴比妥暴露没有增加守卫得分。这些结果表明，γ-氨基丁酸-A受体偏好的GA在PI存在下使用时可能具有有害后果。
Experimental data suggest γ-aminobutyric acid-A receptor preferring general anesthetics (GA) may increase post-operative pain in patients with persistent inflammation (PI). This study was designed to begin to test this prediction. Groups of rats were defined by the presence of inflammation, surgical intervention and/or the type of GA used for a three-hour period of anesthesia. PI was induced with complete Freund's adjuvant. The surgical intervention was a plantar incision. Three mechanistically distinct GAs were used: pentobarbital, ketamine/xylazine and isoflurane. Ongoing pain and hypersensitivity was assessed with guarding behavior analysis and the von Frey test, respectively. There was no influence of GA type on the magnitude or time course of recovery from post-operative hypersensitivity in the absence of PI. In the presence of PI, however, recovery from hypersensitivity was significantly slower in the pentobarbital group than in ketamine/xylazine or isoflurane groups. The pentobarbital effect was significant within three days of surgery, and persisted through the remainder of the testing period. A comparable delay in recovery was observed in pentobarbital-anesthetized inflamed rats not subjected to hindpaw incision. The time to 50% recovery in pentobarbital treated inflamed groups was almost double that in the other groups. No differences were observed between ketamine/xylazine and isoflurane. Pentobarbital exposure did not increase guarding scores. These results suggest that γ-aminobutyric acid-A receptor preferring GAs may have deleterious consequences when used in the presence of PI.