Effect of intrathecal sufentanil and protein kinase C inhibitor on pain threshold and the expression of NMDA receptor/ CGRP in spinal dorsal horn in rats with neuropathic pain / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of intrathecal sufentanil and protein kinase C inhibitor on pain threshold and the expression of N-methyl-D-aspartate receaptors (NMDAR)/calcitonin generelated peptide (CGRP) in spinal dorsal horn in rats with neuropathic pain.@*METHODS@#Fifty-four healthy male Sprague-Dawley rats were randomly divided into 6 groups (9 in each group). The rats in the sham group(Group S) + spared nerve injury (SNI), SP+SNI, and P+SNI were intrathecally injected sufentanil (1 μg), sufentanil (1 μg) and chelerythrine chloride (11 μg), chelerythrine chloride (11 μg) followed by 10 μL normal saline once every day for 14 days postoperatively, respectively. Similarly, rats in the control group (Group C), the sham group (Group S), and SNI model group (Group SNI) were intrathecally injected 20 μL normal saline in the uniform interval. Pain behaviours were measured on Day 1 pre-surgery and on Day 1, 2, 7, and 14 after the intrathecal injection. The expressions of NMDAR and CGRP in the spinal dorsal horn of L5 segment were determined by immunohistochemistry on Day 2, 7, and 14 after the intrathecal injection.@*RESULTS@#Compared with Group C and Group S, mechanical allodynia threshold in group SNI was decreased after the surgery (P<0.01), and expressions of NMDAR and CGRP immunoreactive soma in the spinal dorsal horn was significantly increased (P<0.01). Mechanical stimulation pain threshold was elevated in Group S+SNI, Group P+SNI, and Group SP+SNI compared with Group SNI (P<0.01), while expressions of NMDAR and CGRP immunoreactive soma in Group S+SNI, Group P +SNI, and Group SP+SNI were significantly decreased (P<0.05 or 0.01).@*CONCLUSION@#Intrathecal administration of sulfentanil and protein kinase C inhibitor can provide significant antinociception in rats with neuropathic pain and obviously inhibit the upregulation of NMDAR and CGRP expressions in the spinal dorsal horn of SNI rat models.

The changes of haemodynamics and cerebral state index during double-lumen endobronchial intubation with glidescope ranger video laryngoscope and macintosh direct laryngoscope / 中国医师杂志

Objective To observe the changes of haemodynamics and cerebral state index during double-lumen endobronchial intubation with glidescope ranger video laryngoscope (GSVL) and macintosh direct laryngoscope (MDLS). Methods Forty-eight ASA Ⅰ or Ⅱ patients aged 35 ～ 67 yrs were enrolled in this study, who were scheduled for elective pulmonary cancer or cancer of esophagus radical correction tients were random divided into 2 groups( n =24 each), GSVL group and MDLS group. After anesthesia was induced, all patients were given a score of Cormack grading under MDLS and GSVL, and then endobronchial intubation was performed. Noninvasive BP and HR were recorded before and after induction of anesthesia, during endobronchial intubation and after endobronchial intubation was completed for 1,2, 3, 4,5 min. The CSI was continuously monitored and recorded before and after induction of anesthesia, and after endobronchial intubation for 1 ～ 2 min and 3 ～ 5 min. Results Compared with MDLS group, the rate of Cormack grade 1 was significant higher in GSVL group (91% vs 58% ) ( P ＜0. 01 ). BP of two groups at T1 and T5 ～ T7 were significantly decreased compared to T0 values ( P ＜0. 01 ). Endobronchial intubation (T2 ～T4) caused significant increase in BP and HR compared to post-induction values(T1 ) ( P ＜0. 01).The highest values of HR after intubation exceeded even their baseline values before induction of anesthesia.The haemodynamic responses to endobronchial intubation in GSVL group at T2 ～ T4 were significantly different from those in MDLS group( P ＜0. 05). CSI of two groups at T1 was significantly decreased compared to To values( P ＜0. 01 ), CSI of two groups at T2 induced significant increase compared to T1 values, and the increase of CSI in MDLS group was stronger than that in GSVL group( P ＜0.01). Condusion The haemodynamic responses produced by orotracheal intubation using GSVL had more obvious advantages than MDLS, but GSVL seemed to provide a clear view of glottis and a little change CSI effect.