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쥐의 포르말린 시험에서 척수강 Sildenafil의 항통각효과에 대한 GABA<sub>B</sub> 수용체 조절성
김웅모,윤명하,이형곤,한용구,김여옥,황란희,최금화,Kim, Woong Mo,Yoon, Myung Ha,Lee, Hyung Gon,Han, Yong Gu,Kim, Yeo Ok,Huang, Lan Ji,Cui, Jin Hua 대한통증학회 2007 The Korean Journal of Pain Vol.20 No.2
Background: A phosphodiesterase 5 inhibitor, sildenafil, has been effective against nociception. Several lines of evidence have demonstrated the role of the GABAergic pathway in the modulation of nociception. The impact of the GABA receptors on sildenafil was studied using the formalin test at the spinal level. Methods: Male SD rats were prepared for intrathecal catheterization. The formalin test was induced by subcutaneous injection of formalin solution. The change in the activity of sildenafil was examined after pre-treatment with GABA receptor antagonists ($GABA_A$ receptor antagonist, bicuculline; $GABA_B$ receptor antagonist, saclofen). Results: Intrathecal sildenafil dose-dependently attenuated the flinching observed during phase 1 and 2 in the formalin test. The antinociceptive effect of sildenafil was reversed by the $GABA_B$ receptor antagonist (saclofen) but not by the $GABA_A$ receptor antagonist (bicuculline) in both phases. Conclusions: Intrathecal sildenafil suppressed acute pain and the facilitated pain state. The antinociception of sildenafil is mediated via the $GABA_B$ receptor, but not the $GABA_A$ receptor, at the spinal level.
척수신경 결찰 모형에서 Morphine 내성 유도가 Gabapentin의 항이질통 효과에 미치는 영향
최금화 ( Jin Hua Cui ),이형곤 ( Hyung Gon Lee ),김웅모 ( Woong Mo Kim ),배홍범 ( Hong Beom Bae ),윤명하 ( Myung Ha Yoon ),최정일 ( Jeong Il Choi ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.56 No.1
Background: Morphine is more effective in inflammatory or acute pain than neuropathic pain. Recently, some reports demonstrated that the development and maintenance of opioid tolerance and neuropathic pain have similar aspects. Here, we evaluated whether morphine tolerance affects the anti-allodynic effect of gabapentin in spinal-nerve ligated rat. Methods: Male Sprague-Dawley rats weighing 100-120 g received L5,6 spinal nerve ligation to induce neuropathic pain. Rats showing allodynia were implanted with intrathecal (i.t.) catheter to administer the experimental drugs into the subarachnoid space. To induce olerance to morphine, 15 μg of morphine was injected via i.t. catheter twice a day for 7 days, and the effect of i.t. gabapentin on the paw withdrawal threshold was examined using the von Frey test before and after the development of morphine tolerance. Results: Ligation of spinal nerves decreased the paw withdrawal threshold. Intrathecal morphine initially increased the paw withdrawal threshold, but this effect decreased gradually over time. However, morphine tolerance did not influence the effect of gabapentin on withdrawal threshold. Conclusions: Morphine tolerance did not affect gabapentin efficacay in a neuropathic pain model. (Korean J Anesthesiol 2009;56:74~8)
Propofol과 Remifentanil을 이용한 목표농도조절 주입 전정맥마취에서 이중관 기관내관 삽관 시 혈역학적 반응을 억제하는 Remifentanil의 효과처 농도
허봉하 ( Bong Ha Heo ),윤명하 ( Myung Ha Yoon ),이형곤 ( Hyung Gon Lee ),김웅모 ( Woong Mo Kim ) 대한마취과학회 2009 Korean Journal of Anesthesiology Vol.57 No.1
Background: This study was undertaken to determine the effect-site concentration of remifentanil for blunting hemodynamic responses to double lumen endobronchial intubation during target controlled infusion (TCI)-total intravenous anesthesia (TIVA) using 4.0 μg/ml of propofol with remifentanil. Methods: Sixty patients (American society of anesthesiologists physical status classification 1 or 2) were randomly allocated according to the target effect-site concentration of remifentanil (R3.0: remifentanil 3.0 ng/ml; R3.5: remifentanil 3.5 ng/ml; R4.0: remifentanil 4.0 ng/ml). The effect-site concentration of propofol at loss of consciousness was recorded. Mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) were recorded at just before remifentanil administration (baseline), at the time of target effect site concentration of remifentanil and propofol, at just before intubation and 1, 2, 3 min after intubation. Results: MAP was significantly increased compared with baseline at 1, 2 min after intubation in R3.0, but was significantly decreased in R4.0. MAP of R3.5 was not different from the baseline after intubation. HR was significantly decreased compared with baseline at the time of target effect site concentration of propofol and immediate before intubation in R3.5 and R4.0. After intubation, HR was significantly increased compared with baseline at only 1 min after intubation and returned to the baseline in R3.0. However, HR was continuously decreased in R4.0. Conclusions: These findings suggest that effective target effect-site concentration of remifentanil for blunting hemodynamic responses to double lumen endotracheal intubation was 3.5 ng/ml during TCI-TIVA using 4.0 μg/ml of propofol with remifentanil. (Korean J Anesthesiol 2009; 57: 8~12)