Ball M, McQuay H J, Moore R A, Allen M C, Fisher A, Sear J
Lancet. 1985 Apr 6;1(8432):784-6. doi: 10.1016/s0140-6736(85)91448-5.
Intravenous morphine infusions were given to 20 patients in the intensive-care unit to provide sedation and analgesia. In 10 of the patients renal impairment was already present or developed during intensive care. Plasma morphine concentrations for a given dose of morphine and morphine clearance depended on renal function; dose-related plasma morphine concentrations rose as renal function deteriorated. Reduced morphine clearance leads to increased elimination half-life of the drug, and neurological impairment caused by unrecognised high concentrations of morphine could result in an incorrect diagnosis of cerebral damage in patients in intensive care.
对重症监护病房的20名患者进行了静脉注射吗啡输注，以提供镇静和镇痛作用。其中10名患者在重症监护期间已存在肾功能损害或出现肾功能损害。给定剂量吗啡的血浆吗啡浓度和吗啡清除率取决于肾功能；随着肾功能恶化，与剂量相关的血浆吗啡浓度会升高。吗啡清除率降低会导致药物消除半衰期延长，而未被识别的高浓度吗啡引起的神经功能损害可能导致对重症监护患者脑损伤的错误诊断。
