奈福泮与临床常用镇痛药对犬术后镇痛效果的比较
发布时间：2018-10-23 11:38
【摘要】：奈福泮是一种非麻醉性镇痛药,对中、重疼痛有良好的镇痛效果,对呼吸抑制较轻,无耐受性和依赖性,已有研究表明肌内注射20mg,相当于12mg吗啡的效应。奈福泮在人医临床术后镇痛方面已广泛应用,在兽医临床未得到人们的认可。前期课题组研究了奈福泮在犬镇痛方面的效果,表明其安全有效,在临床镇痛方面具有良好的应用前景。 通过建立犬子宫卵巢摘除术致痛模型,研究围术期肌注奈福泮与国内宠物临床常用镇痛药(痛立定和美洛昔康)的镇痛效果,比较观察不同时间点生理指标、疼痛评分及应激相关指标的变化,了解三种药物对犬临床镇痛效果及对免疫应激方面影响,为奈福泮在犬临床镇痛的实际应用奠定基础。 选取本地健康成年雌犬24只,随机分为4组(A、B、C、D组),四组均摘除子宫卵巢进行致痛。A组不采取任何镇痛措施,B组在术后0h(术后待犬清醒,可正常行走时)肌肉注射奈福泮注射液(2mg/kg),C组在术后Oh肌肉注射痛立定注射液(4mg/kg),D组在术后0h肌肉注射美洛昔康注射液(0.2mg/kg)。术后0、2、4、6、8、12、24h选用墨尔本大学疼痛评分量表、双盲试验法对镇痛效果进行评价。各时间点检测生理指标、采集血样,用酶联免疫吸附试验检测各免疫应激相关指标。 结果表明：(1)疼痛评分结果显示术后0h,各组评分均超过11分,组间无显著差异(P0.05)。随后用药各组评分均降低,6h后各组评分与对照组比较无显著差异性。(2)心率和血压的变化趋势相近,术后0h犬心率和血压显著升高(P0.05),随后用药各组心率和血压均接近生理水平,6h后四组无显著差异(P0.05)。呼吸频率在术后0h明显增加,在术后2-4h B、C、D与A组比较呈显著降低趋势(P0.05),在6h后四组无显著差异。犬的体温在术后呈现升高趋势,在术后2-6h B、C、D组接近正常水平,与A组比较有显著差异(P0.05),6h后四组体温无显著性差异。(3)应激相关指标结果显示术后各组血浆皮质醇、儿茶酚胺和胰岛素浓度均升高,术后B、C、D组与A组比较,上升趋势缓慢,B组较C、D组持续时间稍长。前列腺素检测结果显示A组术后均较术前显著升高(P0.05), B、C、D组在2-6h与A组相应时间比较显著降低(P0.05),6h后四组无显著差异。(4)术后各实验组肿瘤坏死因子-α和白介素-6含量均升高,B、C、D组与A组比较上升较缓慢。 综合试验结果得出：(1)肌肉注射2mg/kg奈福泮用于犬术后镇痛与痛立定和美洛昔康比较,奈福泮镇痛效果强、持续时间长(有效镇痛时间可达6h)。(2)肌肉注射2mg/kg奈福泮用于犬术后镇痛与痛立定和美洛昔康比较,奈福泮具有较长时间抗应激、抗伤害作用,对免疫作用抑制轻微。
[Abstract]:Nafopam is a kind of non-anesthetic analgesic, which has good analgesic effect on moderate and severe pain, and has less inhibition of respiration, and has no tolerance and dependence. It has been shown that intramuscular injection of 20 mg is equivalent to that of 12mg morphine. Nafopam has been widely used in postoperative analgesia in human medicine and has not been recognized in veterinary clinic. The effect of nafopam on canine analgesia was studied, which indicated that Nefopam was safe and effective, and had a good application prospect in clinical analgesia. The analgesic effects of nafopam intramuscularly injected during perioperative period were studied by establishing a canine model of pain induced by ovariectomies, and the analgesic effects of Tongliding and meloxicam were compared and observed at different time points. The changes of pain score and stress related indexes were used to understand the effects of three drugs on clinical analgesia and immune stress in dogs, which laid a foundation for the practical application of nafopam in canine clinical analgesia. Twenty-four local healthy adult female dogs were randomly divided into 4 groups (group A). All of the four groups were excised to cause pain. Group A did not take any analgesic measures, and group B was awake at 0 h after operation. Nafopam injection was injected intramuscularly during normal walking (2mg/kg), C group received Oh intramuscular injection of Tongliding injection (4mg/kg), D group 0 h after operation) and meloxicam injection (0.2mg/kg) was injected intramuscularly. The pain scale of the University of Melbourne was used to evaluate the analgesic effect by double blind test. Physiological indexes were detected at each time point, blood samples were collected and enzyme linked immunosorbent assay (Elisa) was used to detect the relative indexes of immune stress. The results showed that: (1) the pain score showed that the scores of each group exceeded 11 at 0 h after operation, and there was no significant difference between the groups (P0.05). After 6 hours, there was no significant difference between each group and the control group. (2) the change trend of heart rate and blood pressure was similar. The heart rate and blood pressure increased significantly at 0 h after operation (P0.05), then the heart rate and blood pressure of each group were close to physiological level, and there was no significant difference among the four groups after 6 hours (P0.05). The respiratory frequency increased significantly at 0 h after operation, and decreased significantly at 2-4 h after operation compared with group A (P0.05), but there was no significant difference among the four groups after 6 h. The body temperature of dogs showed an increasing trend after operation, and the body temperature of group D was close to the normal level at 2-6 hours after operation, which was significantly different from that of group A (P0.05), but there was no significant difference in body temperature of the four groups after 6 hours. (3) the results of stress related indexes showed that the plasma cortisol in each group was higher than that in group A. The concentrations of catecholamine and insulin were both increased. The trend of increase was slower in group B than in group A, and the duration was longer in group B than in group C. The results of prostaglandin detection showed that the levels of tumor necrosis factor- 伪 and interleukin-6 in group A were significantly higher than those before operation (P0.05), and the levels of tumor necrosis factor- 伪 (TNF- 伪) and interleukin-6 (IL-6) in group B were significantly lower than those in group A at 2-6 h (P0.05). (4) there was no significant difference in the levels of tumor necrosis factor- 伪 and interleukin-6 between group A and group A after 6 hours. Compared with group A, group D increased more slowly. The results showed that: (1) compared with Tongliding and meloxicam, the analgesia effect of nafopam by intramuscular injection of 2mg/kg nafopam was stronger than that of Tongliding and meloxicam. The duration was longer (the effective analgesia time was up to 6h). (2). The intramuscular injection of 2mg/kg nafopam for postoperative analgesia in dogs was compared with Tongliding and meloxicam. Nefopam had a long time anti-stress, anti-nociceptive effect, and had a slight inhibition on immune response.
【学位授予单位】：东北农业大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：S859.7;S857.12
本文编号：2289119
[Abstract]:Nafopam is a kind of non-anesthetic analgesic, which has good analgesic effect on moderate and severe pain, and has less inhibition of respiration, and has no tolerance and dependence. It has been shown that intramuscular injection of 20 mg is equivalent to that of 12mg morphine. Nafopam has been widely used in postoperative analgesia in human medicine and has not been recognized in veterinary clinic. The effect of nafopam on canine analgesia was studied, which indicated that Nefopam was safe and effective, and had a good application prospect in clinical analgesia. The analgesic effects of nafopam intramuscularly injected during perioperative period were studied by establishing a canine model of pain induced by ovariectomies, and the analgesic effects of Tongliding and meloxicam were compared and observed at different time points. The changes of pain score and stress related indexes were used to understand the effects of three drugs on clinical analgesia and immune stress in dogs, which laid a foundation for the practical application of nafopam in canine clinical analgesia. Twenty-four local healthy adult female dogs were randomly divided into 4 groups (group A). All of the four groups were excised to cause pain. Group A did not take any analgesic measures, and group B was awake at 0 h after operation. Nafopam injection was injected intramuscularly during normal walking (2mg/kg), C group received Oh intramuscular injection of Tongliding injection (4mg/kg), D group 0 h after operation) and meloxicam injection (0.2mg/kg) was injected intramuscularly. The pain scale of the University of Melbourne was used to evaluate the analgesic effect by double blind test. Physiological indexes were detected at each time point, blood samples were collected and enzyme linked immunosorbent assay (Elisa) was used to detect the relative indexes of immune stress. The results showed that: (1) the pain score showed that the scores of each group exceeded 11 at 0 h after operation, and there was no significant difference between the groups (P0.05). After 6 hours, there was no significant difference between each group and the control group. (2) the change trend of heart rate and blood pressure was similar. The heart rate and blood pressure increased significantly at 0 h after operation (P0.05), then the heart rate and blood pressure of each group were close to physiological level, and there was no significant difference among the four groups after 6 hours (P0.05). The respiratory frequency increased significantly at 0 h after operation, and decreased significantly at 2-4 h after operation compared with group A (P0.05), but there was no significant difference among the four groups after 6 h. The body temperature of dogs showed an increasing trend after operation, and the body temperature of group D was close to the normal level at 2-6 hours after operation, which was significantly different from that of group A (P0.05), but there was no significant difference in body temperature of the four groups after 6 hours. (3) the results of stress related indexes showed that the plasma cortisol in each group was higher than that in group A. The concentrations of catecholamine and insulin were both increased. The trend of increase was slower in group B than in group A, and the duration was longer in group B than in group C. The results of prostaglandin detection showed that the levels of tumor necrosis factor- 伪 and interleukin-6 in group A were significantly higher than those before operation (P0.05), and the levels of tumor necrosis factor- 伪 (TNF- 伪) and interleukin-6 (IL-6) in group B were significantly lower than those in group A at 2-6 h (P0.05). (4) there was no significant difference in the levels of tumor necrosis factor- 伪 and interleukin-6 between group A and group A after 6 hours. Compared with group A, group D increased more slowly. The results showed that: (1) compared with Tongliding and meloxicam, the analgesia effect of nafopam by intramuscular injection of 2mg/kg nafopam was stronger than that of Tongliding and meloxicam. The duration was longer (the effective analgesia time was up to 6h). (2). The intramuscular injection of 2mg/kg nafopam for postoperative analgesia in dogs was compared with Tongliding and meloxicam. Nefopam had a long time anti-stress, anti-nociceptive effect, and had a slight inhibition on immune response.
【学位授予单位】：东北农业大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：S859.7;S857.12
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