Changes in mechanical, chemical, and thermal sensitivity of the cornea after topical application of nonsteroidal anti-inflammatory drugs
Changes in mechanical, chemical, and thermal sensitivity of the cornea after topical application of nonsteroidal anti-inflammatory drugs
复制标题
DOI：
10.1167/iovs.04-0884
复制
发表时间：
2005-01-01
影响因子：
4.4
通讯作者：
Belmonte, C
中科院分区：
文献类型：
--
作者：
Acosta, MC;Berenguer-Ruiz, L;Belmonte, C
目的。除了众所周知的抗炎作用外，一些非甾体抗炎药 (NSAID) 似乎还具有镇痛作用。在人类受试者中，研究了局部施用两种商业非甾体抗炎药双氯芬酸钠（扶他林；诺华，巴塞尔，瑞士）和氟比洛芬（Ocuflur；艾尔建，尔湾，加利福尼亚州）引起的角膜机械、化学和热刺激引起的感觉阈值和强度的变化。方法。使用气体感觉计测量了 10 名年轻健康受试者的角膜敏感性。对角膜中心施加化学刺激（空气中 10%-70% CO2）、机械刺激（0-264 mL/min）和热刺激（角膜温度在正常值周围 -4.5°C 和 +3°C 之间变化）。在脉冲结束时，以 10 厘米连续视觉模拟量表 (VAS) 对诱发感觉的心理物理属性的强度和感知幅度进行评分。阈值表示为引起 VAS 评分 >0.5 的刺激强度。分别在两天内测量每个受试者双眼的敏感性，其中一天未经治疗，另一天在局部施用 0.03% 氟比洛芬（七名受试者）或 0.1% 双氯芬酸钠（六名受试者）后 30 分钟。 结果。双氯芬酸显着减弱高强度机械、化学和热刺激引起的所有感觉参数。氟比洛芬使机械和化学刺激引起的感觉略有减弱，仅对最大强度的化学刺激（70% CO2）引起的刺激才变得显着。没有一种药物显着改变不同刺激的检测阈值。结论。氟比洛芬对角膜刺激引起的感觉的影响非常有限，而双氯芬酸则降低了不同方式刺激引起的感觉的强度，表明该药物对所有类型的角膜感觉纤维都有轻微的局部麻醉作用。这种麻醉作用可以解释双氯芬酸局部应用于发炎的人眼后所报道的镇痛效果。
PURPOSE. In addition to their well-known anti-inflammatory actions, some of the nonsteroidal anti-inflammatory drugs (NSAIDs) appear to have an analgesic effect. In human subjects, the changes in threshold and intensity of sensations evoked by mechanical, chemical, and thermal stimulation of the cornea induced by topical administration of two commercial NSAIDs, diclofenac sodium (Voltaren; Novartis, Basel, Switzerland) and flurbiprofen (Ocuflur; Allergan, Irvine, CA), were studied.METHODS. Corneal sensitivity was measured in 10 young, healthy subjects with a gas esthesiometer. Chemical (10%-70% CO2 in air), mechanical (0-264 mL/min), and thermal ( corneal temperature changes between -4.5degreesC and +3degreesC around the normal value) stimuli were applied to the center of the cornea. The intensity and perceived magnitude of the psychophysical attributes of the evoked sensation were scored at the end of the pulse in a 10-cm, continuous visual analog scale (VAS). The threshold was expressed as the stimulus intensity that evoked a VAS score >0.5. Sensitivity was measured in both eyes of each subject on two separate days, one without treatment and the other 30 minutes after topical application of 0.03% flurbiprofen (seven subjects) or 0.1% diclofenac sodium (six subjects).RESULTS. Diclofenac attenuated significantly all the sensation parameters evoked by high-intensity mechanical, chemical, and thermal stimuli. Flurbiprofen produced a slight reduction of the sensations evoked by mechanical and chemical stimulation that became significant only for the irritation caused by chemical stimuli of maximum intensity (70% CO2). None of the drugs modified significantly the detection threshold of the different stimuli.CONCLUSIONS. Flurbiprofen had a very limited effect on sensations evoked by corneal stimulation, whereas diclofenac reduced the intensity of sensations evoked by stimuli of different modality, suggesting a mild local anesthetic effect of this drug on all types of corneal sensory fibers. Such anesthetic action could explain the analgesic effect that has been reported after topical application of diclofenac in inflamed human eyes.