新斯的明硬外镇痛的实验与临床研究

EXPERIMENTAL AND CLINICAL STUDIES OF ANALGESIA WITH EPIDURAL NEOSTIGMINE

摘要:

目的 :探讨硬外新斯的明的镇痛效应。方法 :本研究分成两个部分。第一部分研究不同剂量的新斯的明在不同人体实验疼痛模型中的镇痛效应。第二部分研究不同剂量的新斯的明对手术后痛的镇痛效果。结果 :第一部分 :0 .5mg和 1.0mg新斯的明对上肢及 0 .5mg新斯的明对下肢没有镇痛作用 ;1.0mg新斯的明对下肢有镇痛作用 ,但对不同性质疼痛的反应作用不同。第二部分 :0 .5mg和 1.0mg新斯的明均降低了术后痛VAS评分 (P <0 .0 1)。硬外新斯的明有明显的副作用 ,包括心率降低 ,胃肠运动亢进。结论 :硬外新斯的明可产生与剂量相关的镇痛作用及副作用

Abstract:

Objective: To study the analgesia efficacy of epidural neostigmine. Methods: The study consists of two parts: part 1, the analgesic action of neostigmine in normal humans, part 2, the analgesic action of neostigmine in postoperative pain patients. Results: There was no analgesic effect on upper extremities after epidural administration of 0.5mg or 1.0mg of neostigmine. There was analgesia on lower extremities following 1.0mg but not 0.5mg neostigmine. In post operative pain patients epidural neostigmine 0.5 or 1.0mg induced dose related analgesia as assessed by VAS scores. Conclusion: Epidural neostigmine produced dose rated analgesic effect in human experimental pain model, and in patients with post operative pain. Its aversive side effects (bradycardia, increased GI movement) prevented it from clinical application.