Warner M A, Hosking M P, Gray J R, Squillace D L, Yunginger J W, Orszulak T A
Department of Anesthesiology, Mayo Medical School, Rochester, MN 55905.
J Cardiothorac Vasc Anesth. 1991 Oct;5(5):481-4. doi: 10.1016/1053-0770(91)90123-b.
This study, using an improved histamine assay, repeated previous studies that demonstrated large doses of morphine for induction of anesthesia in patients undergoing coronary artery bypass grafting were associated with histamine release. Thirty randomized patients received infusions of either morphine, 1 mg/kg, oxymorphone, 0.2 mg/kg, or fentanyl, 50 micrograms/kg, over a 10-minute period for induction of anesthesia prior to surgery. There were no significant changes in plasma histamine levels in individual patients or among drug groups. The discrepancy between the present histamine results and those previously reported using similar protocols is due, in part, to variations in plasma histamine measurements that can occur using the less reproducible, older assays for histamine. During routine inductions, large doses of morphine, oxymorphone, or fentanyl administered by infusion do not appear to stimulate release of clinically significant plasma levels of histamine.
本研究采用改良的组胺测定法，重复了先前的研究，这些研究表明，在接受冠状动脉搭桥术的患者中，大剂量吗啡用于诱导麻醉与组胺释放有关。30名随机分组的患者在手术前10分钟内接受吗啡（1mg/kg）、羟吗啡酮（0.2mg/kg）或芬太尼（50μg/kg）静脉输注以诱导麻醉。个体患者或药物组之间的血浆组胺水平无显著变化。目前组胺检测结果与先前使用类似方案报告的结果之间的差异，部分原因在于使用较难重复的旧组胺检测方法时，血浆组胺测量可能存在差异。在常规诱导过程中，通过静脉输注给予大剂量吗啡、羟吗啡酮或芬太尼似乎不会刺激释放具有临床意义的血浆组胺水平。
