Discovery Research Laboratories, Nippon Shinyaku Co., Ltd., Kisshoin, Minami-ku, Kyoto, Japan.
Neurourol Urodyn. 2013 Jan;32(1):98-103. doi: 10.1002/nau.22274. Epub 2012 Jun 5.
(±)-Tramadol hydrochloride (tramadol) is a widely used analgesic that stimulates the µ-opioid receptor and inhibits the reuptake of serotonin and noradrenalin. Although tramadol is also known to inhibit the micturition reflex in rats, its effects on urethral continence function have not been reported. We therefore examined whether intravenous tramadol (1, 3, and 10 mg/kg) affects intraurethral pressure, bladder leak point pressure, and leak volume in urethane-anesthetized female rats.
(1) The intraurethral pressure was recorded with a microtip pressure transducer placed at the maximum pressure zone of the intrinsic urethral sphincter. (2) Gentle pressure was directly applied to the saline-filled bladder with a cotton bud until leakage occurred, and the bladder pressure at the moment of leakage was taken as the bladder leak point pressure. (3) The leak volume was measured as the amount of fluid leakage from the urethral orifice after electrical stimulation of abdominal muscles.
Tramadol significantly increased the intraurethral pressure. Both tramadol and morphine increased the bladder leak point pressure and decreased the leak volume. These changes were reversed by subcutaneous pretreatment with naloxone.
Tramadol improved urethral function and inhibited urinary incontinence through µ-opioid receptors.
（±）-盐酸曲马多（曲马多）是一种广泛使用的镇痛药，它刺激μ-阿片受体并抑制 5-羟色胺和去甲肾上腺素的再摄取。尽管曲马多也已知可抑制大鼠的排尿反射，但尚未报道其对尿道控尿功能的影响。因此，我们研究了静脉注射曲马多（1、3 和 10mg/kg）是否会影响乌拉坦麻醉雌性大鼠的尿道内压、膀胱漏点压和漏尿量。
（1）通过放置在固有尿道括约肌最大压力区的微tip 压力传感器记录尿道内压。（2）用棉花球直接对充满生理盐水的膀胱施加轻柔压力，直到发生泄漏，泄漏时的膀胱压力作为膀胱漏点压。（3）通过电刺激腹部肌肉测量从尿道口漏出的液体量作为漏尿量。
曲马多显著增加了尿道内压。曲马多和吗啡均增加了膀胱漏点压并减少了漏尿量。这些变化可被皮下预先给予纳洛酮逆转。
曲马多通过μ-阿片受体改善了尿道功能并抑制了尿失禁。
