Intraplantar formalin injection produces early (Phase 1, 0- to 5-minute) and late (Phase 2, 15-plus minutes after injection) nociceptive responses, including painlike behavior and activation of primary afferents and dorsal horn neurons. Although we and others have reported that opioid analgesia or local anesthesia during Phase 1 does not reduce the overall magnitude of behavioral and/or neuronal responses during Phase 2, recent studies concluded that spinal sensitization during Phase 1 significantly contributes to the magnitude of painlike behavior during Phase 2. In this article, we provide additional evidence that Phase 1 and Phase 2 behaviors are independent. We found that remifentanil analgesia during Phase 1 does not reduce Phase 2, regardless of route of administration, duration of analgesia, types of behavior assessed, formalin concentration, concomitant use of general anesthesia, or concomitant administration of an N-methyl-D-aspartate (NMDA) antagonist. We suggest that Phase 1 behaviors compared with Phase 2 behaviors in the formalin test are not an appropriate model of spinal sensitization or preemptive opioid analgesia. Instead, early opioid administration delayed the onset of edema produced by formalin. Because the antiedema effect of remifentanil was reversed with a peripherally acting opioid receptor antagonist, we suggest that opioids interact with peripheral receptors to temporarily delay the onset and offset of formalin-induced edema.

译文

足底福尔马林注射产生早期 (第1阶段,0至5分钟) 和晚期 (第2阶段,注射后15分钟以上) 的伤害性反应,包括疼痛行为和初级传入神经元和背角神经元的激活。尽管我们和其他人报告说,第1阶段的阿片类镇痛或局部麻醉不会降低第2阶段的行为和/或神经元反应的总体幅度,但最近的研究得出结论,第1阶段的脊柱敏化显着有助于疼痛行为的幅度在第2阶段。在本文中,我们提供了其他证据,表明阶段1和阶段2的行为是独立的。我们发现,无论给药途径,镇痛持续时间,评估行为类型,福尔马林浓度,全身麻醉的同时使用或N-甲基-D-天冬氨酸 (NMDA) 拮抗剂的同时给药,瑞芬太尼在1期镇痛不会减少2期镇痛。我们建议,福尔马林试验中的1期行为与2期行为相比,不是脊柱致敏或先发制人阿片类镇痛的合适模型。相反,早期使用阿片类药物会延迟福尔马林产生的水肿的发作。由于瑞芬太尼的抗水肿作用被外周作用的阿片受体拮抗剂逆转,因此我们建议阿片类药物与外周受体相互作用以暂时延迟福尔马林诱导的水肿的发作和抵消。

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