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Published in: BMC Anesthesiology 1/2015

Open Access 01-12-2015 | Research article

A comparison of intrathecal magnesium and ketamine in attenuating remifentanil-induced hyperalgesia in rats

Authors: Jiehao Sun, Hai Lin, Xiaona Feng, Jiaojiao Dong, Emmanuel Ansong, Xuzhong Xu

Published in: BMC Anesthesiology | Issue 1/2015

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Abstract

Background

Activation of NMDA receptors play an important role in the development of remifentanil-induced hyperalgesia. We hypothesized that in addition to ketamine, intrathecal MgSO4 could also relieve thermal and mechanical hyperalgesia in rats.

Methods

Initially, 24 Sprague–Dawley rats were divided into control group, remifentanil group, surgical incision group and remifentanil combined with surgical incision group to create an experimental model. Subsequently, 40 rats were divided into control group, model group, model group plus 100 μg MgSO4, 300 μg MgSO4 and 10 μg ketamine respectively. Paw withdrawal mechanical thresholds and paw withdrawal thermal latency tests were performed at −24 h, 2 h, 6 h, 24 h, 48 h, 72 h and 7 day after the surgical procedure. After behavior assessment on the 7th day, remifentanil was given again to ascertain whether or not NMDA antagonists could suppress the re-exposure of remifentanil-induced hyperalgesia.

Results

Remifentanil administration plus surgical incision induced significant postoperative hyperalgesia, as indicated by decreased paw withdrawal mechanical thresholds and paw withdrawal thermal latency to mechanical and thermal stimulation. In addition to ketamine, intrathecal MgSO4 (100, 300 μg) dose-dependently reduced remifentanil-induced mechanical and thermal hyperalgesia. Ketamine had less mechanical hyperalgesia in 6 h (p = 0.018), 24 h (p = 0.014) and 48 h (p = 0.011) than 300 μg MgSO4. There was no difference in inhibiting thermal hyperalgesia between the group ketamine and group MgSO4 (300 μg). The rats were given remifentanil again 7 days later after the first exposure of remifentanil. The hyperalgesic effect induced by re-exposure of remifentanil was not reversed in any groups of MgSO4 or ketamine.

Conclusions

In addition to ketamine, intrathecal administration of MgSO4 dose-dependently reduced remifentanil-induced hyperalgesia in a surgical incision mode. Re-exposure to remifentanil 1 week later again produced hyperalgesia, and this was not altered by the prior intrathecal treatments in any 4 groups treated with MgSO4 or ketamine.
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Literature
1.
go back to reference Fletcher D, Martinez V. Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis. Brit J Anaesth. 2014;112:991–1004.CrossRefPubMed Fletcher D, Martinez V. Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis. Brit J Anaesth. 2014;112:991–1004.CrossRefPubMed
2.
go back to reference Derrode N, Lebrun F, Levron JC, Chauvin M, Debaene B. Influence of perioperative opioid on postoperative pain after major abdominal surgery: sufentanil TCI versus remifentanil TCI. A randomized, controlled study. Brit J Anaesth. 2003;91:842–9.CrossRefPubMed Derrode N, Lebrun F, Levron JC, Chauvin M, Debaene B. Influence of perioperative opioid on postoperative pain after major abdominal surgery: sufentanil TCI versus remifentanil TCI. A randomized, controlled study. Brit J Anaesth. 2003;91:842–9.CrossRefPubMed
3.
go back to reference Shin SW, Cho AR, Lee HJ, et al. Maintenance anaesthetics during remifentanil-based anaesthesia might affect postoperative pain control after breast cancer. Brit J Anaesth. 2010;105:661–7.CrossRefPubMed Shin SW, Cho AR, Lee HJ, et al. Maintenance anaesthetics during remifentanil-based anaesthesia might affect postoperative pain control after breast cancer. Brit J Anaesth. 2010;105:661–7.CrossRefPubMed
4.
go back to reference Ana C, David C, Asunción R, Paula GN, Margarita MP. Delayed postoperative latent pain sensitization revealed by the systemic administration of opioid antagonists in mice. Eur J Pharmacol. 2011;657:89–96.CrossRef Ana C, David C, Asunción R, Paula GN, Margarita MP. Delayed postoperative latent pain sensitization revealed by the systemic administration of opioid antagonists in mice. Eur J Pharmacol. 2011;657:89–96.CrossRef
5.
go back to reference Joly V, Richebe P, Guignard B, et al. Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine. Anesthesiology. 2005;103:147–55.CrossRefPubMed Joly V, Richebe P, Guignard B, et al. Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine. Anesthesiology. 2005;103:147–55.CrossRefPubMed
6.
go back to reference Chen L, Huang LY. Protein kinase C reduces Mg2+ block of NMDA receptor channels as a mechanism of modulation. Nature. 1992;9:521–3.CrossRef Chen L, Huang LY. Protein kinase C reduces Mg2+ block of NMDA receptor channels as a mechanism of modulation. Nature. 1992;9:521–3.CrossRef
7.
go back to reference Alain C, Van E, Philippe S, Mazoit JX, Marc C, Dan B. Protective effect of prior administration of magnesium on delayed hyperalgesia induced by fentanyl in rats. Can J Anesth. 2006;53:1180–5.CrossRef Alain C, Van E, Philippe S, Mazoit JX, Marc C, Dan B. Protective effect of prior administration of magnesium on delayed hyperalgesia induced by fentanyl in rats. Can J Anesth. 2006;53:1180–5.CrossRef
8.
go back to reference Tufan M, Yasemin G, Dilek O, Ismail G. Magnesium modifies fentanyl-induced local antinociception and hyperalgesia. N-S Arch Pharmacol. 2009;380:415–20.CrossRef Tufan M, Yasemin G, Dilek O, Ismail G. Magnesium modifies fentanyl-induced local antinociception and hyperalgesia. N-S Arch Pharmacol. 2009;380:415–20.CrossRef
9.
go back to reference Liu X, Zhang J, Zhao H, Mei H, Lian Q, ShangGuan W. The effect of propofol on intrathecal morphine-induced pruritus and its mechanism. Anesth Analg. 2014;118:303–9.CrossRefPubMed Liu X, Zhang J, Zhao H, Mei H, Lian Q, ShangGuan W. The effect of propofol on intrathecal morphine-induced pruritus and its mechanism. Anesth Analg. 2014;118:303–9.CrossRefPubMed
10.
go back to reference Brennan TJ, Vandermeulen EP, Gebhart GF. Characterization of a rat model of incisional pain. Pain. 1996;64:493–501.CrossRefPubMed Brennan TJ, Vandermeulen EP, Gebhart GF. Characterization of a rat model of incisional pain. Pain. 1996;64:493–501.CrossRefPubMed
11.
go back to reference Zhang L, Shu R, Wang H, et al. Hydrogen-rich saline prevents remifentanil induced hyperalgesia and inhibits MnSOD nitration via regulation of NR2B-containing NMDA receptor in rats. Neuroscience. 2014;280:171–80.CrossRefPubMed Zhang L, Shu R, Wang H, et al. Hydrogen-rich saline prevents remifentanil induced hyperalgesia and inhibits MnSOD nitration via regulation of NR2B-containing NMDA receptor in rats. Neuroscience. 2014;280:171–80.CrossRefPubMed
12.
go back to reference Célérier E, González JR, Maldonado R, Cabalvro D, Puig MM. Opioid-induced hyperalgesia in a murine model of postoperative pain: role of nitric oxide generated from the inducible nitric oxide synthase. Anesthesiology. 2006;104:546–55.CrossRefPubMed Célérier E, González JR, Maldonado R, Cabalvro D, Puig MM. Opioid-induced hyperalgesia in a murine model of postoperative pain: role of nitric oxide generated from the inducible nitric oxide synthase. Anesthesiology. 2006;104:546–55.CrossRefPubMed
13.
go back to reference Célérier E, Laulin JP, Corcuff JB, Le Moal M, Simonnet G. Progressive enhancement of delayed hyperalgesia induced by repeated heroin administration: a sensitization process. J Neurosci. 2001;21:4074–80.PubMed Célérier E, Laulin JP, Corcuff JB, Le Moal M, Simonnet G. Progressive enhancement of delayed hyperalgesia induced by repeated heroin administration: a sensitization process. J Neurosci. 2001;21:4074–80.PubMed
14.
go back to reference Wang C, Li Y, Wang H, et al. Inhibition of DOR prevents remifentanil induced postoperative hyperalgesia through regulating the trafficking and function of spinal NMDA receptors in vivo and in vitro. Brain Res Bull. 2015;110:30–9.CrossRefPubMed Wang C, Li Y, Wang H, et al. Inhibition of DOR prevents remifentanil induced postoperative hyperalgesia through regulating the trafficking and function of spinal NMDA receptors in vivo and in vitro. Brain Res Bull. 2015;110:30–9.CrossRefPubMed
15.
go back to reference Juni A, Klein G, Pintar JE, Kest B. Nociception increases during opioid infusion in opioid receptor triple knock-out mice. Neuroscience. 2007;147:439–44.CrossRefPubMed Juni A, Klein G, Pintar JE, Kest B. Nociception increases during opioid infusion in opioid receptor triple knock-out mice. Neuroscience. 2007;147:439–44.CrossRefPubMed
16.
go back to reference Waxman AR, Arout C, Caldwell M, Dahan A, Kest B. Acute and chronic fentanyl administration causes hyperalgesia independently of opioid receptor activity in mice. Neurosci Lett. 2009;46:68–72.CrossRef Waxman AR, Arout C, Caldwell M, Dahan A, Kest B. Acute and chronic fentanyl administration causes hyperalgesia independently of opioid receptor activity in mice. Neurosci Lett. 2009;46:68–72.CrossRef
17.
go back to reference Van Dorp EL, Kest B, Kowalczyk WJ, et al. Morphine-6-β-glucuronide rapidly increases pain sensitivity independently of opioid receptor activity in mice and humans. Anesthesiology. 2009;110:1356–63.CrossRefPubMed Van Dorp EL, Kest B, Kowalczyk WJ, et al. Morphine-6-β-glucuronide rapidly increases pain sensitivity independently of opioid receptor activity in mice and humans. Anesthesiology. 2009;110:1356–63.CrossRefPubMed
18.
go back to reference Li Y, Wang H, Xie K, et al. Inhibition of glycogen synthase kinase-3β prevents remifentanil-induced hyperalgesia via regulating the expression and function of spinal N-methyl-D-aspartate receptors in vivo and vitro. PLoS One. 2013;8:e77790.CrossRefPubMedPubMedCentral Li Y, Wang H, Xie K, et al. Inhibition of glycogen synthase kinase-3β prevents remifentanil-induced hyperalgesia via regulating the expression and function of spinal N-methyl-D-aspartate receptors in vivo and vitro. PLoS One. 2013;8:e77790.CrossRefPubMedPubMedCentral
19.
go back to reference Hahnenkamp K, Nollet J, Van Aken HK, et al. Remifentanil directly activates human N-methyl-D-aspartate receptors expressed in Xenopus laevis oocytes. Anesthesiology. 2004;100:1531–7.CrossRefPubMed Hahnenkamp K, Nollet J, Van Aken HK, et al. Remifentanil directly activates human N-methyl-D-aspartate receptors expressed in Xenopus laevis oocytes. Anesthesiology. 2004;100:1531–7.CrossRefPubMed
20.
go back to reference Guntz E, Dumont H, Roussel C, et al. Effects of remifentanil on N-methyl-d-aspartate receptor: an electrophysiologic study in rat spinal cord. Anesthesiology. 2005;102:1235–41.CrossRefPubMed Guntz E, Dumont H, Roussel C, et al. Effects of remifentanil on N-methyl-d-aspartate receptor: an electrophysiologic study in rat spinal cord. Anesthesiology. 2005;102:1235–41.CrossRefPubMed
21.
go back to reference Celerier E, Simonnet G, Maldonado R. Prevention of fentanyl-induced delayed pronociceptive effects in mice lacking the protein kinase C gene. Neuropharmacology. 2004;46:264–72.CrossRefPubMed Celerier E, Simonnet G, Maldonado R. Prevention of fentanyl-induced delayed pronociceptive effects in mice lacking the protein kinase C gene. Neuropharmacology. 2004;46:264–72.CrossRefPubMed
22.
go back to reference Ram KC, Eisenberg E, Haddad M, Pud D. Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain - new perspective of opioid- induced hyperalgesia. Pain. 2008;139:431–8.CrossRefPubMed Ram KC, Eisenberg E, Haddad M, Pud D. Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain - new perspective of opioid- induced hyperalgesia. Pain. 2008;139:431–8.CrossRefPubMed
23.
go back to reference Bennett AD, Everhart AW, Hulsebosch CE. Intrathecal administration of an NMDA or a non-NMDA receptor antagonist reduces mechanical but not thermal allodynia in a rodent model of chronic central pain after spinal cord injury. Brain Res. 2000;859:72–82.CrossRefPubMed Bennett AD, Everhart AW, Hulsebosch CE. Intrathecal administration of an NMDA or a non-NMDA receptor antagonist reduces mechanical but not thermal allodynia in a rodent model of chronic central pain after spinal cord injury. Brain Res. 2000;859:72–82.CrossRefPubMed
24.
go back to reference Hama A, Jeung Woon L, Jacqueline S. Differential efficacy of intrathecal NMDA receptor antagonists on inflammatory mechanical and thermal hyperalgesia in rats. Eur J Pharmacol. 2003;459:49–58.CrossRefPubMed Hama A, Jeung Woon L, Jacqueline S. Differential efficacy of intrathecal NMDA receptor antagonists on inflammatory mechanical and thermal hyperalgesia in rats. Eur J Pharmacol. 2003;459:49–58.CrossRefPubMed
25.
go back to reference Xiao WH, Bennett GJ. Magnesium suppresses neuropathic pain response in rats via a spinal site of action. Brain Res. 1994;666:168–72.CrossRefPubMed Xiao WH, Bennett GJ. Magnesium suppresses neuropathic pain response in rats via a spinal site of action. Brain Res. 1994;666:168–72.CrossRefPubMed
26.
go back to reference Van Elstraete AC, Sitbon P, Trabold F, Mazoti JX, Benhamou D. A single dose of intrathecal morphine in rat induces long-lasting hyperalgesia: the protective effect of prior administration of ketamine. Anesth Analg. 2005;101:1750–6.CrossRefPubMed Van Elstraete AC, Sitbon P, Trabold F, Mazoti JX, Benhamou D. A single dose of intrathecal morphine in rat induces long-lasting hyperalgesia: the protective effect of prior administration of ketamine. Anesth Analg. 2005;101:1750–6.CrossRefPubMed
27.
go back to reference Lim HS, Kim JM, Choi JG, et al. Intrathecal ketamine and pregabalin at sub-effective doses synergistically reduces neuropathic pain without motor dysfunction in mice. Biol Pharm Bull. 2013;36:125–30.CrossRefPubMed Lim HS, Kim JM, Choi JG, et al. Intrathecal ketamine and pregabalin at sub-effective doses synergistically reduces neuropathic pain without motor dysfunction in mice. Biol Pharm Bull. 2013;36:125–30.CrossRefPubMed
28.
go back to reference Yoshito T, Eiru S, Toshihiko K, Isao S. Antihyperalgesic effects of intrathecally administered magnesium sulfate in rats. Pain. 2000;84:175–9.CrossRef Yoshito T, Eiru S, Toshihiko K, Isao S. Antihyperalgesic effects of intrathecally administered magnesium sulfate in rats. Pain. 2000;84:175–9.CrossRef
29.
go back to reference Cheng JK, Lai YJ, Chen CC, Cheng CR, Chiou LC. Magnesium chloride and rutbenium red attenuated the antialldodynic effect of intrathecal gabapentin in a rat model of postoperative pain. Anesthesiology. 2003;98:1472–9.CrossRefPubMed Cheng JK, Lai YJ, Chen CC, Cheng CR, Chiou LC. Magnesium chloride and rutbenium red attenuated the antialldodynic effect of intrathecal gabapentin in a rat model of postoperative pain. Anesthesiology. 2003;98:1472–9.CrossRefPubMed
30.
go back to reference Echevarria G, Elgueta F, Fierro C, et al. Nitrous oxide (N2O) reduces postoperative opioid-induced hyperalgesia after remifentanil propofol anaesthesia in humans. Brit J Anaesth. 2011;107:959–65.CrossRefPubMed Echevarria G, Elgueta F, Fierro C, et al. Nitrous oxide (N2O) reduces postoperative opioid-induced hyperalgesia after remifentanil propofol anaesthesia in humans. Brit J Anaesth. 2011;107:959–65.CrossRefPubMed
31.
go back to reference Cabañero D, Campillo A, Célérier E, Romero A, Puig MM. Pronociceptive effects of remifentanil in a mouse model of postsurgical pain: effect of a second surgery. Anesthesiology. 2009;111:1334–45.CrossRefPubMed Cabañero D, Campillo A, Célérier E, Romero A, Puig MM. Pronociceptive effects of remifentanil in a mouse model of postsurgical pain: effect of a second surgery. Anesthesiology. 2009;111:1334–45.CrossRefPubMed
32.
go back to reference Chen JQ, Wu Z, Wen LY, Miao JZ, Hu YM, Xue R. Preoperative and postoperative analgesic techniques in the treatment of patients undergoing transabdominal hysterectomy: a preliminary randomized trial. BMC Anesthesiol. 2015;15:70.CrossRefPubMedPubMedCentral Chen JQ, Wu Z, Wen LY, Miao JZ, Hu YM, Xue R. Preoperative and postoperative analgesic techniques in the treatment of patients undergoing transabdominal hysterectomy: a preliminary randomized trial. BMC Anesthesiol. 2015;15:70.CrossRefPubMedPubMedCentral
33.
go back to reference Wilson JA, Garry EM, Anderson HA, et al. NMDA receptor antagonist treatment at the time of nerve injury prevents injury-induced changes in spinal NR1 and NR2B subunit expression and increases the sensitivity of residual pain behaviours to subsequently administered NMDA receptor antagonists. Pain. 2005;117:421–32.CrossRefPubMed Wilson JA, Garry EM, Anderson HA, et al. NMDA receptor antagonist treatment at the time of nerve injury prevents injury-induced changes in spinal NR1 and NR2B subunit expression and increases the sensitivity of residual pain behaviours to subsequently administered NMDA receptor antagonists. Pain. 2005;117:421–32.CrossRefPubMed
Metadata
Title
A comparison of intrathecal magnesium and ketamine in attenuating remifentanil-induced hyperalgesia in rats
Authors
Jiehao Sun
Hai Lin
Xiaona Feng
Jiaojiao Dong
Emmanuel Ansong
Xuzhong Xu
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2015
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-016-0235-9

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