Nakayoshi Tomoko, Kawasaki Naruo, Suzuki Yutaka, Yasui Yutaka, Nakada Koji, Ishibashi Yoshio, Hanyu Nobuyoshi, Urashima Mitsuyoshi, Yanaga Katsuhiko
Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
J Gastrointest Surg. 2007 May;11(5):648-54. doi: 10.1007/s11605-006-0065-z.
Morphine is known to delay gastric emptying and intestinal transit, although epidural morphine is believed to decrease postoperative complications. However, these findings are still controversial and based only on clinical observations. We investigated the effects of epidural morphine administration on gut motility by measuring interdigestive migrating complex after open surgery in dogs. Twenty-eight beagles were divided into four groups (n = 7 each) to receive epidural saline (control group), epidural morphine, epidural ropivacaine, or low-dose continuous intravenous morphine. Strain gauge force transducers were sutured under open operation to the serosal surface of the stomach, duodenum, jejunum, and ileum to monitor gut motility. Time of appearance of first interdigestive migrating complex from the stomach propagated to the distal intestine was significantly shorter in the group that received epidural morphine compared with the other three groups. These results suggest that epidural administration of morphine may facilitate recovery from paralytic ileus after open abdominal surgery, perhaps through its effects on the central nervous system.
众所周知,吗啡会延迟胃排空和肠道运输,尽管硬膜外吗啡被认为可减少术后并发症。然而,这些发现仍存在争议,且仅基于临床观察。我们通过测量犬类开腹手术后的消化间期移行性复合波,研究了硬膜外注射吗啡对肠道运动的影响。28只比格犬被分为四组(每组n = 7),分别接受硬膜外生理盐水(对照组)、硬膜外吗啡、硬膜外罗哌卡因或低剂量持续静脉注射吗啡。在开腹手术中,将应变片式力传感器缝合到胃、十二指肠、空肠和回肠的浆膜表面,以监测肠道运动。与其他三组相比,接受硬膜外吗啡的组中,从胃传播至远端肠道的首个消化间期移行性复合波出现的时间明显更短。这些结果表明,硬膜外注射吗啡可能有助于开腹手术后麻痹性肠梗阻的恢复,这可能是通过其对中枢神经系统的作用实现的。