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吗啡和阿芬太尼透过犬和猴的脊髓硬脑膜、蛛网膜和软脑膜的通透性。

Morphine and alfentanil permeability through the spinal dura, arachnoid, and pia mater of dogs and monkeys.

作者信息

Bernards C M, Hill H F

机构信息

Department of Anesthesiology, University of Washington, Seattle 98195.

出版信息

Anesthesiology. 1990 Dec;73(6):1214-9. doi: 10.1097/00000542-199012000-00020.

Abstract

Little information exists about which spinal meninx is the principal permeability barrier between the epidural space and the spinal cord or about what physicochemical properties of drug molecules govern their meningeal permeability. To better understand these aspects of epidural pharmacokinetics, the authors measured the permeability of morphine and alfentanil through the different components of the spinal meninges-dura mater, arachnoid mater, and pia mater-of dogs and monkeys in vitro. Live meningeal tissue from either species (dura mater alone, pia mater alone, or intact dura-arachnoid-pia) was placed between two fluid reservoirs of a temperature-controlled diffusion cell. The permeability of the tissues to each opioid was determined by placing the opioid in one of the reservoirs of the diffusion cell and measuring the rate at which the drug diffused through the tissue and appeared in the second reservoir. The arachnoid mater was found to be the major meningeal diffusion barrier between the epidural space and the spinal cord. Alfentanil was 3.7 times more permeable than morphine through all three meninges, suggesting that increased lipid solubility increases meningeal permeability. However, neither lipid solubility nor molecular weight adequately explained the difference in permeability between morphine and alfentanil. The authors conclude that this in vitro model has significant utility for studies aimed at predicting in vivo meningeal permeability and hence the potency and rapidity of action of any opioid administered by the epidural route.

摘要

关于哪种脊髓脑脊膜是硬膜外间隙与脊髓之间的主要渗透屏障,或者药物分子的哪些物理化学性质决定其脑脊膜通透性,目前所知甚少。为了更好地理解硬膜外药代动力学的这些方面,作者在体外测量了吗啡和阿芬太尼通过狗和猴子的脊髓脑脊膜不同成分——硬脑膜、蛛网膜和软脑膜——的通透性。来自任一物种的活体脑脊膜组织(单独的硬脑膜、单独的软脑膜或完整的硬脑膜 - 蛛网膜 - 软脑膜)被置于温度可控的扩散池的两个流体储库之间。通过将阿片类药物置于扩散池的一个储库中,并测量药物通过组织扩散并出现在第二个储库中的速率,来确定组织对每种阿片类药物的通透性。发现蛛网膜是硬膜外间隙与脊髓之间主要的脑脊膜扩散屏障。阿芬太尼通过所有三层脑脊膜的通透性比吗啡高3.7倍,这表明脂溶性增加会提高脑脊膜通透性。然而,脂溶性和分子量都不能充分解释吗啡和阿芬太尼之间通透性的差异。作者得出结论,这种体外模型对于旨在预测体内脑脊膜通透性以及由此预测通过硬膜外途径给药的任何阿片类药物的效力和作用速度的研究具有重要用途。

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