Thorén T, Tanghöj H, Mattwil M, Järnerot G
Department of Anesthesiology and Intensive Care, Orebro Medical Center Hospital, Sweden.
Acta Anaesthesiol Scand. 1989 Feb;33(2):174-80. doi: 10.1111/j.1399-6576.1989.tb02885.x.
The influence of a painful stimulus and lumbar epidural morphine on gastric emptying, the orocecal transit time and small intestinal transit were studied in nine healthy volunteers. Acetaminophen absorption was used as a measure of the rate of gastric emptying. Orocecal transit time was determined by measuring the end-expiratory hydrogen concentration. Small intestinal transit was calculated from measurements of the orocecal transit time and gastric emptying. Cold pain stress with intermittent immersion of the feet in ice-cold water was used as a painful stimulus. Each volunteer was investigated on 3 different days: once after receiving 4 mg of epidural morphine and during cold pain; once during cold pain; and once under control conditions without pain and epidural morphine. Immersion of the feet in ice-cold water was always very painful, but was more tolerable during epidural morphine analgesia. The increase in blood pressure which accompanied the cold pain was the same whether this pain was induced without or during epidural morphine analgesia. Gastric emptying, orocecal transit time and small intestinal transit were delayed during epidural morphine analgesia compared with the findings under the control and plain cold pain conditions. Cold pain stress alone did not influence gastric emptying, orocecal transit time or intestinal transit. To conclude, epidural morphine in itself delayed gastric emptying, orocecal transit and transit through the small intestine in healthy volunteers.
在9名健康志愿者中研究了疼痛刺激和腰椎硬膜外注射吗啡对胃排空、口盲肠转运时间和小肠转运的影响。对乙酰氨基酚的吸收被用作胃排空速率的指标。口盲肠转运时间通过测量呼气末氢气浓度来确定。小肠转运通过口盲肠转运时间和胃排空的测量值来计算。将双脚间歇性浸入冰冷水中的冷痛应激用作疼痛刺激。每位志愿者在3个不同的日子接受研究：一次是在接受4毫克硬膜外吗啡后并处于冷痛状态时；一次是在冷痛期间；一次是在无疼痛和硬膜外吗啡的对照条件下。将双脚浸入冰冷水中总是非常疼痛，但在硬膜外吗啡镇痛期间更可耐受。无论冷痛是在无硬膜外吗啡镇痛还是在硬膜外吗啡镇痛期间诱发，伴随冷痛的血压升高都是相同的。与对照和单纯冷痛条件下的结果相比，硬膜外吗啡镇痛期间胃排空、口盲肠转运时间和小肠转运均延迟。单独的冷痛应激不影响胃排空、口盲肠转运时间或肠道转运。总之，硬膜外吗啡本身会延迟健康志愿者的胃排空、口盲肠转运和小肠转运。
