The sensitization of a broad spectrum of sensory nerve fibers in arat model of acute postoperative pain and its response tointrathecal pharmacotherapy

摘要

Further understanding of pathophysiology of postoperative acute pain is necessary for its better management. The methodology of current threshold (CT) determination by using sine-wave stimuli at 3 frequencies has been used to selectively and quantitatively analyze the function of the subsets of fibers (i.e., frequency of 5, 250, and 2000 Hz recruits C-, A5-, and Ap-fibers, respectively). This study investigated how surgical incision would affect the CTs, and then assessed the efficacy of intrathecal pharmacotherapy. The CT required to evoke a paw withdrawal response was assessed over time at stimulus frequencies of 5 Hz (CT5), 250 Hz (CT250), and 2000 Hz (CT2000) in rats that had undergone surgical incision of the plantar skin and muscle. The CTs at all frequencies significantly decreased immediately after the incision. The decreased thresholds gradually recovered during the first week post-surgery. CT5 and CT250 (but not CT2000) remained significantly low even on day 7 post-surgery. Morphine at 5 mug/10 muL i.t. significantly reversed CT5 and CT250. NBQX (a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid [AMPA]/kainate receptor antagonist) at 1.9 or 3.8 mug/10 muL i.t. significantly increased the thresholds over the pre-surgery threshold levels at all frequencies. MK-801 (TV-methyl D-aspartate [NMDA] receptor antagonist) up to 13.5 mug/10 muL i.t. did not significantly affect CTs at any frequencies. In conclusion, a broad spectrum of sensory fibers (A?, A8, and C) is sensitized at the spinal and/or peripheral level in the postoperative acute pain state. Spinal AMPA/kainate receptors but not NMDA receptors play a significant role in this sensitization. ? 2008 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.