Role of spinal cyclooxygenase-2 and prostaglandin E2 in fentanyl-induced hyperalgesia in rats

Br J Anaesth. 2018 Apr;120(4):827-835. doi: 10.1016/j.bja.2017.11.103.

Abstract

Background: Accumulated evidence suggests that spinal cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) may be implicated in the development of opioid-induced hyperalgesia.

Methods: Rats received subcutaneous fentanyl injections at different doses (20-80 μg kg-1), four separate times at 15-min intervals. Some rats only received fentanyl (60 μg kg-1 × 4 doses) with or without surgical incision. Fentanyl-induced hyperalgesia was evaluated via a tail-pressure or paw-withdrawal test. The concentrations of spinal COX-2, EP-1 receptor (EP-1R) mRNA, and PGE2 were measured. The effects of the COX-2 inhibitor, parecoxib (intraperitoneal 10 mg kg-1), or the EP-1R antagonist, SC51089 (intraperitoneal 100 μg kg-1), on hyperalgesia and spinal PGE2 were examined.

Results: Acute repeated injections of fentanyl dose-dependently induced mechanical hyperalgesia, which reached a peak at the 1st day and persisted for 1-4 days postinjection. This hyperalgesia could be partly or totally prevented by the pretreatment of either parecoxib or SC51089. Consistently, the levels of spinal COX-2 mRNA and PGE2 were also dose-dependently increased, reaching a peak at the first day and persisting for 2 days postinjection. Pretreatment with parecoxib could block the increase in spinal PGE2 and had no effects on spinal COX-2 and EP-1R mRNA. Fentanyl injection enhanced incision-induced mechanical and thermal hyperalgesia.

Conclusions: Acute repeated fentanyl administration dose-dependently produced mechanical hyperalgesia and augmented surgery induced postoperative hyperalgesia. This behavioural change was paralleled with an increase in spinal COX-2 mRNA and PGE2 after fentanyl administration. Inhibition of COX-2 or blockade of EP-1R can partly or totally prevent hyperalgesia.

Keywords: cyclooxygenase-2; fentanyl; opioid-induced hyperalgesia; prostaglandin E2; surgery.

MeSH terms

  • Analgesics, Opioid / administration & dosage*
  • Animals
  • Cyclooxygenase 2 / metabolism*
  • Dinoprostone / metabolism*
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Fentanyl / administration & dosage*
  • Hyperalgesia / metabolism*
  • Male
  • Rats
  • Rats, Sprague-Dawley
  • Spinal Cord / metabolism*

Substances

  • Analgesics, Opioid
  • Cyclooxygenase 2
  • Dinoprostone
  • Fentanyl