Long-term Effect of Sciatic Nerve Block with Slow-release Lidocaine in a Rat Model of Postoperative Pain
Long-term Effect of Sciatic Nerve Block with Slow-release Lidocaine in a Rat Model of Postoperative Pain
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DOI：
10.1097/aln.0b013e3181d4f66f
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发表时间：
2010-06-01
期刊：
影响因子：
8.8
通讯作者：
Saito, Shigeru
中科院分区：
文献类型：
--
作者：
Tobe, Masaru;Obata, Hideaki;Saito, Shigeru
背景：术后疼痛管理是预防围手术期并发症的重要措施。作者在大鼠术后疼痛模型上观察了利多卡因控释片对坐骨神经阻滞的效果。方法：作者研制了一种新型的聚乳酸-羟基乙酸缓释利多卡因片剂。在雄性Spraogue-Dawley大鼠(术后疼痛模型)中，作者在切开爪子之前，在同侧坐骨神经附近应用了SRLS、单独的利多卡因或聚乳酸-乙醇酸(对照)。用von Frey纤维评价机械超敏反应，并检测脊髓背角L4-L5节段c-fos的表达。结果：30%(w/w)的SRLS体外持续释放利多卡因1周。SRLS治疗组大鼠戒断阈值在各时间点(2 h~7 d)均高于对照组。利多卡因组的戒断阈值仅在爪部切开后2 h高于对照组。伤后2、5、48h，SRLS组c-fos免疫反应阳性神经元平均数低于对照组，伤后5、48h低于利多卡因组。在组织病理学上，SRLS治疗组的肌肉和神经组织中仅有轻微的炎症迹象。结论：SRLS单独治疗1周可抑制脊髓背角痛觉过敏和c-fos的表达。缓释局麻药有望用于术后疼痛的治疗。
Background: Postoperative pain management is important for preventing perioperative complications. The authors examined the effectiveness of controlled-release lidocaine for sciatic nerve block in a rat model of postoperative pain.Methods: The authors created a novel slow-release lidocaine sheet (SRLS) with polylactic-coglycolic acid. In male Sprague-Dawley rats (postoperative pain model), the authors applied the SRLS, lidocaine alone, or polylactic-coglycolic acid (control) near the ipsilateral sciatic nerve just before making the paw incision. Mechanical hypersensitivity was assessed using von Frey filaments, and c-fos expression was examined in the spinal cord dorsal horn at segments L4-L5. Neurotoxicity and muscle toxicity were also evaluated via histopathology.Results: The SRLS (30%, w/w) continuously released lidocaine for 1 week in vitro. The withdrawal threshold in the SRLS-treated group was higher than that in the control group at all time points measured (2 h to 7 days). The withdrawal threshold in the lidocaine-treated group was higher than that in the control group only at 2 h after paw incision. The mean number of c-fos immunoreactive neurons in the SRLS-treated group was lower than in the control group at 2, 5, and 48 h after paw incision and lower than in the lidocaine-treated group at 5 and 48 h after paw incision. On histopathology, signs of inflammation were only slightly present in the muscle and nerve tissues of the SRLS-treated group.Conclusions: Single treatment with the SRLS inhibited hyperalgesia and c-fos expression in the spinal cord dorsal horn for 1 week. Slow-release local anesthetics are promising for the management of postoperative pain.