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疼痛學會雜誌第三十卷第一期

疼痛學會雜誌第二十九卷第一期

  • 隨選雜誌議題

H_1 Histamine Blocking Agents: Doxylamine and Pheniramine, Have a Potent Cutaneous Analgesic Effect in Rats

關鍵字   doxylamine;pheniramine;infiltrative cutaneous analgesia;第一型組織胺阻斷劑;局部止痛劑;Doxylamine;Pheniramine 

 作者  游嘉鴻(Chia-Hung Yu);林耀聰(Yao-Tsung Lin);王立楷(Li-Kai Wang);謝介平(Ja-Ping Shieh);王志中(Jhi-Joung Wang);褚錦承(Chin-Chen Chu);陳家銘(Chia-Ming Chen)

並列摘要


背景:第一型組織胺阻斷劑被廣泛地應用於治療過敏反應。這些藥物與胺類或酯類局部麻 醉劑有相似的環狀結構。此外,他們也被證實有明顯的鈉離子通道阻斷活性。據此,我們假設H_1組織胺阻斷劑有局部浸潤止痛效果,並以大鼠模式來評估之。材料與方法:實驗一,我們篩選八種第一型組織胺阻斷劑,將藥物皮下注射於大鼠背部皮膚,再由不知情的觀察者於注射部位給與六次VonFrey filament針刺刺激,六次針刺刺激皆無反應定義為百分之百最大可能效果。據此,選出兩種具局部止痛強效及最無皮膚毒性的氏組織胺阻斷劑(每組有六隻大鼠),進行後續的劑量反應曲線及作用時間的研究。實驗二,H_1組織胺阻斷劑在表皮止痛強度以劑量反應曲線及ED_(75)時間反應曲線,並與兩種現有的局部麻醉藥lidocaine及bupivacaine比較。在實驗三,我們評估比較這兩種H_1組織胺阻斷劑與lidocaine及bupivacaine在ED_(25)、ED_(50)及ED_(75)的作用時間。結果:在等當量基礎下,doxylamine及pheniramine比其他的H_1組織胺阻斷劑,具有較強且最低皮膚毒性的局部止痛效果。經由比較劑量反應曲線及ED_(75)的時間作用曲線。我們發現藥效強度的排序是:bupivacaine > doxylamine ≒ lidocaine > pheniramine。作用時間依序是:doxylamine > pheniramine ≒ bupivacaine > lidocaine。結論:在第一型組織胺阻斷劑中,doxylamine及pheniramine有最強的表皮浸潤止痛效果。他們的藥效強度比bupivacaine為弱但與lidocaine類似。除此之外,doxylamine有最長的作用時間。

摘要


Background: Histamine-1 (H_1) antihistamines are widely used for the treatment of allergic diseases. These drugs have a similar aromatic ring and amine structure with that of local anesthetics, and proved having a prominent sodium channel blocking activity. Therefore, we performed a dose-response study to test the local analgesic effects of H_1 antihistamines in a rat model. Material and methods: In study 1, eight H_1, antihistamines were subcutaneous injected to the shaved dorsal skin to screen the local analgesic effect in S.D. rats (6 rats in each group). The inhibition of the cutaneous trunci muscle reflex to pinpricks with No. 15 Von Frey filament was quantitatively evaluated. No response to six pinpricks was defined as 100% maximum possible effect. Two of the most potent H_1 antihistamines were then chosen in study 2 for further dose-response studies, and compared with two clinically used local anesthetics: lidocaine and bupivacaine. Moreover, in study 3, we compared the antinociceptive duration of test drugs at ED_(25)、ED_(50) and ED_(73) doses。Result: On an equimolar basis, we found doxylamine and pheniramine possessed potent local analgesic effect. The rank of potency was as following rank: bupivacaine > doxylamine ≒ lidocaine > pheniramine. The ranking of anesthetic durations were: doxylamine > pheniramine ≒ bupivacaine > lidocaine Conclusion: Both doxylamine and pheniramine are potent infiltrative analgesics. The potencies are weaker than that of bupivacaine but similar to that of lidocaine. Moreover, doxylamine had a long duration of drug effect.
  • 本期雜誌簡介與主編的話

第三十卷第一期主編的話


本期的疼痛醫學雜誌在大家的共同努力下出版了,我們延續了過往的水凖,在本期有三篇原著,分別是1.劉玉成醫師等所發表的cholecyctokinin-B的受體拮抗劑可抑制嗎啡引起的hyperalgesia,2.黃安年醫師等臨床觀察到Nalbuphine合併Parecoxib可控制術後疼痛,3.台北榮總護理部黃明輝的成果顯示:良好疼痛管理(GPM)可以顯著改善疼痛; 本期有一篇綜論,是謝孟勳醫師等所發表的有關嗎啡類藥物引起腸道菌叢不良在嗎啡耐受中的角色,值得一讀; 另外有二篇病例報告,一篇是熱門的豎脊肌平面阻斷術(ESP block)在兒童切肝手術的應用; 一篇是椎盤攝影(discogram)正常的病人合併高頻熱凝治療術可以減緩下背痛。上述文章皆有一定的水凖,並經本刊審查過,希望對大家在疼痛醫學上的研究與治療有所幫助,更希望大家繼續支持與投稿本雜誌。

2021-09-30
 

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