Department of Psychology, Washington State University, Vancouver, Washington 98686, USA.
J Pain. 2012 Aug;13(8):799-807. doi: 10.1016/j.jpain.2012.05.005. Epub 2012 Jul 3.
Systemic administration of morphine typically produces greater tolerance than higher efficacy mu-opioid receptor (MOPr) agonists such as fentanyl. The objective of the present study was to test this relationship by measuring antinociceptive efficacy and tolerance to morphine and fentanyl microinjected into the ventrolateral periaqueductal gray (vlPAG). MOPr agonist efficacy was evaluated by microinjecting the irreversible opioid receptor antagonist β-funaltrexamine hydrochloride (β-FNA) into the vlPAG prior to a dose-response analysis of morphine and fentanyl antinociception. In contrast to systemic administration of morphine and fentanyl, microinjection of these drugs into the vlPAG had similar efficacy as measured by similar reductions in maximal antinociception following β-FNA administration. Analysis of tolerance revealed a rightward shift in the dose-response curve to a single pretreatment with morphine, but not fentanyl. The magnitude of tolerance to morphine was comparable following 1, 4, or 8 pretreatments. Tolerance to fentanyl also was evident following 4 or 8 microinjections. These data are surprising in that antinociceptive efficacy appears to vary depending on the site of administration. Moreover, the similar efficacy following microinjection of morphine and fentanyl into the vlPAG was associated with comparable tolerance, with the 1 exception of no tolerance to acute administration of fentanyl.
These data reveal that antinociceptive tolerance following vlPAG administration of opioids develops rapidly and is evident with both morphine and fentanyl, and the magnitude is relatively consistent regardless of the number of pretreatments.
与芬太尼等更高效能的μ-阿片受体(MOPr)激动剂相比,吗啡的全身给药通常会产生更大的耐受性。本研究的目的是通过测量吗啡和芬太尼经脑室周围导水管周围灰质(vlPAG)微注射后的镇痛疗效和耐受性来检验这种关系。MOPr 激动剂的效能通过在进行吗啡和芬太尼镇痛剂量反应分析之前,将不可逆的阿片受体拮抗剂β-氟纳曲胺盐酸盐(β-FNA)微注射到 vlPAG 中来评估。与吗啡和芬太尼的全身给药不同,这些药物经 vlPAG 微注射后具有相似的效能,表现在给予β-FNA 后最大镇痛作用的相似降低。对耐受性的分析表明,单次吗啡预处理后,剂量-反应曲线向右移位,但芬太尼没有。吗啡的耐受性程度在 1、4 或 8 次预处理后相似。4 或 8 次微注射后也出现了对芬太尼的耐受性。这些数据令人惊讶,因为镇痛疗效似乎取决于给药部位。此外,吗啡和芬太尼经 vlPAG 微注射后的相似疗效与相似的耐受性相关,除了急性给予芬太尼没有耐受性这 1 个例外。
这些数据显示,在 vlPAG 给予阿片类药物后,镇痛耐受性迅速发展,并且吗啡和芬太尼都存在这种情况,而且无论预处理次数多少,其程度都相对一致。