Detection of acute tolerance to the analgesic and nonanalgesic effects of remifentanil infusion in a rabbit model
Detection of acute tolerance to the analgesic and nonanalgesic effects of remifentanil infusion in a rabbit model
复制标题
DOI：
10.1213/01.ane.0000083370.80416.38
复制
发表时间：
2003-11-01
影响因子：
5.7
通讯作者：
Hanaoka, K
中科院分区：
文献类型：
--
作者：
Hayashida, M;Fukunaga, A;Hanaoka, K
尽管瑞芬太尼能迅速产生急性镇痛耐受性，但急性耐受性是否也会发展为非止痛作用尚不清楚。我们研究了瑞芬太尼持续输注对兔模型的镇痛和心肺功能的影响。10只气管切开的新西兰大白兔被放置在允许合理自由活动的吊带上，这些兔子有动脉和静脉通道。在自主呼吸清醒动物上，瑞芬太尼以0.3µg·kg~(-1)·min~(-1)的恒速静注360分钟。在注射瑞芬太尼期间，反复评估镇静/止痛剂和心肺变量，包括对夹住前爪行为无反应的动物数量(无反应者)，以及引起抬头所需的皮下电刺激阈值(HLT：疼痛检测/唤醒阈值)和逃避运动反应(EMT：疼痛耐受阈值)。在开始输注的60-120分钟内，无应答者的数量、HLT、EMT和PaCO2显著增加，而血压、心率和呼吸频率下降。此后，尽管继续输液，AT变量仍恢复到输液前水平。这些结果表明，在瑞芬太尼输注期间，由于其止痛和心肺功能的影响，会产生急性耐受性。
Although acute tolerance to analgesia develops rapidly with remifentanil, it is unknown whether acute tolerance also develops to its nonanalgesic effects. We investigated the analgesic and cardiorespiratory effects of remifentanil during a continuous infusion in a rabbit model. Ten tracheotomized New Zealand White rabbits with arterial and venous accesses were placed on a sling that allowed for reasonably free movement. In spontaneously breathing conscious animals, remifentanil was infused IV at a constant-rate of 0.3 mug(.)kg(-1.)min(-1) for 360 min. Sedative/analgesic and cardiorespiratory variables were assessed repeatedly during remifentanil infusion, including the number of animals behaviorally unresponsive to clamping the forepaw (nonresponders) and subcutaneous electrical stimulation thresholds required to elicit head lift (HLT: pain detection/arousal threshold) and escape movement responses (EMT: pain tolerance threshold). Within 60-120 min of starting the infusion, the number of nonresponders, HLT, EMT, and PaCO2 increased significantly, whereas blood pressure, heart rate, and respiratory rate decreased. Thereafter, at variables returned towards preinfusion levels despite continuing infusion. These results indicate that during a remifentanil infusion acute tolerance develops for both its analgesic and cardiorespiratory effects.