Kona-Boun Jean-Jacques, Pibarot Philippe, Quesnel Andrée
Department of Clinical Sciences (Anesthesiology), Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada.
Vet Anaesth Analg. 2003 Oct;30(4):257-64. doi: 10.1046/j.1467-2995.2003.00076.x.
A 5-year-old German Shepherd dog which presented for total hip replacement developed myoclonus and urinary retention after the subarachnoid injection of preservative-free morphine. Myoclonus was resistant to treatment, except pentobarbital anesthesia. Urinary retention was treated with bethanechol and subsided within a few days. Involuntary muscular activity can result from the epidural, subarachnoid or systemic injection of various opioid drugs, or as a result of the toxic or irritant effect of preservatives or autologous blood. The latter were not causative factors in this case. Opioid agonist inhibition of central inhibitory neurotransmitter action may have explained the myoclonus. Postoperative urinary retention was attributed to the spinal action of morphine inhibiting efferent parasympathetic nervous activity.
一只5岁的德国牧羊犬接受全髋关节置换手术，在蛛网膜下注射无防腐剂吗啡后出现肌阵挛和尿潴留。除戊巴比妥麻醉外，肌阵挛对治疗有抵抗性。尿潴留用氨甲酰甲胆碱治疗，几天后消退。硬膜外、蛛网膜下或全身注射各种阿片类药物，或由于防腐剂或自体血的毒性或刺激作用，都可能导致不自主肌肉活动。后两者并非该病例的致病因素。阿片类激动剂对中枢抑制性神经递质作用的抑制可能解释了肌阵挛。术后尿潴留归因于吗啡的脊髓作用抑制传出性副交感神经活动。
