李 燕 王国 年△ 林 鹰 杨 光 徐德生.NMDAR 在瑞芬太尼引起痛觉过敏机制和防治的研究进展[J].现代生物医学进展英文版,2015,15(6):1148-1150. |
NMDAR 在瑞芬太尼引起痛觉过敏机制和防治的研究进展 |
The Role of N-methyl-D-aspartate Receptor in the Mechanism andPrevention of Remifentanil Induced Hyperalgesia |
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DOI: |
中文关键词: 瑞芬太尼 NMDAR 痛觉过敏 预防 |
英文关键词: Remifentanil NMDAR Hyperalgesia Prevention |
基金项目:哈尔滨市科技创新人才研究专项资金(201 2RFXXSO41) |
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中文摘要: |
阿片 类药物引起痛觉过敏(opioid-induced hyperalgesia, OIH)是指暴露于阿片 类药物的患者出 现一种痛阈降低和对正常疼痛
刺激的超敏反应为特点的感觉异常现象。 瑞芬太尼是一种 滋 受体激动剂, 且由于起效迅速,时量半衰期短而恒定, 重复用 药亦无
蓄积, 这些良好的药代动力 学特点导致它发生的痛觉过敏现象也明显频于、强于其他阿片 类药物。 N- 甲基 -D- 天冬氨酸受体
( N-methyl-D-aspartate receptor, NMDAR)激活在产生超敏现象中是非常重要的。 但是关于 NMDAR 在瑞芬太尼诱发痛觉过敏的
机制尚未完全清楚, 仍然缺乏系统的预防和治疗方案。 本文简 要介绍了 NMDAR, 总结了 NMDAR 在瑞芬太尼引起痛觉过敏的机
制 中的作用, 归纳了 临床上一些 NMDAR 拮抗药物来预防瑞芬太尼引起的痛 觉过敏现象,以期对后续的围 术期的疼痛 管理提供
理论依据。 |
英文摘要: |
Opioid-induced hyperalgesia(OIH) is the state of decreased sensory thresholds and increased sensitivity to normal pain
stimulation induced by opioid exposure. Remifentanil is an ultra-short acting 滋-opioid receptor agonist that is associated with predictable
and rapid recovery independent of dose and duration of infusion. Shorter acting opioids cause more rapid and frequent hyperalgesia. The
activation of N-methyl-D-aspartate receptor (NMDAR) has a critical role in the development of OIH. The involvement of NMDAR
signaling underlying remifentanil-induced hyperalgesia have not been completely established, thus, there are no efficacious preventions
or therapies for the problem. The review introduces background information on receptor, summariing the role of NMDAR in the
remifentanil-induced hyperalgesia and some NMDAR antagonist clinical drugs to preventing the hyperalgesia phenomenon, providing a
theoretical basis for follow-up of perioperative pain management. |
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