Artikel
Potential impact of opioids on functional outcome in translational model of closed head injury and decompressive craniectomy
Potentieller Einfluss der Opioidgabe auf die funktionelle Erholung in translationellen Modell des geschlossenen Schädelhirntraumas und der Entlastungskraniektomie
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Autoren
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Jacek Szczygielski
- Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland; Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Institut für Neuropathologie, Homburg/Saar, Deutschland; Fakultät der Medizin, Universität Rzeszów, Rzeszów, Poland
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Lisa Franziska Albrecht
- Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
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Yannik Bullinger
- Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
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Karsten Schwerdtfeger
- Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
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Joachim Oertel
- Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: The choice of anesthetics and analgesics in translational neurotrauma research remains challenging, since the application of potentially neuroprotective drugs (i.e. opiates) may bias the functional and physiological parameters and consequently obscure the result of otherwise well-designed study. We hypothesize, that administration of buprenorphine (a drug commonly used for pain management in laboratory animals) may impact the early functional recovery after trauma and decompressive craniectomy in our translational murine model.
Methods: Isoflurane-anesthetized male CD-1 mice were subjected to severe head trauma according to Closed Head Injury (CHI) protocol and thereafter to microsurgical temporoparietal decompressive craniectomy. Here, the animals were randomly assigned to one of the therapeutic group (n=7 each group), one receiving maximal non-pharmacologic pain management, the other being given buprenorphine 0.1 mg/kg BW s.c. throughout the surgical procedure. At the time point 24h after trauma, the mortality was documented and the neurological function was assessed according to Neurology Severity Score (NSS), Beam Balance Score (BBS) and Beam Balancing Time (BBT). The structural changes (including brain edema) were documented using 9.4 Tesla MRI. The impairment scores were expressed as mean ±SEM and compared between both groups using unpaired t-test. Significance was set at p<0.05.
Results: The overall mortality did not differ between both treatment groups. According to functional tests, neither NSS (no opioid: 4.43±1.23 vs. opioid 3.33±1.05; p=0.52, ns) nor BBS (no opioid: 2.71±0.37 vs. opioid 2.50±0.51; p=0.73, ns) nor BBT (no opioid: 32.57±16.04 vs. opioid 54.67±20.12; p=0.40, ns) differed between both groups.
The radiological assessment did not demonstrate any impact of opioid administration on pattern of posttraumatic changes. In particular, brain edema formation and external herniation via craniectomy window did not differ between the groups.
Conclusion: The demonstrated results do not support the hypothesis, that combination of pain-relieving drugs used in our laboratory could potentially skew experimental data. The methodological concern of pain management in animal neurotrauma experiments should consider that functional variables may be affected not only by neuroprotective properties of drugs but also by the effect of unalleviated pain.
