Haghbin Mohammad Ali, Navidi Zia, Romero-Leguizamon Cesar R, Shabani Mohammad
Assistant Professor, Department of Anesthesiology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
PhD Candidate, Department of Drug Design and Pharmacology, School of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Addict Health. 2018 Apr;10(2):95-101. doi: 10.22122/ahj.v10i2.538.
The prevalence of opium addiction among Iranians is considerable. Since endogenous opioid systems may be altered as a consequence of addiction, it is very important to determine the plasma and cerebrospinal fluid (CSF) levels of morphine in Iranian patients addicted to opiates who will undergo surgery.
We obtained CSF and plasma samples from 50 volunteers with an established opioid addiction pattern. Samples were analyzed using high-performance liquid chromatography (HPLC). Additionally, frequency of nausea and vomiting, baseline heart rate (BHR), and systolic blood pressure (SBP) were recorded within the surgery and postoperatively during a 10-min interval.
84% of participants were men with a median age of 39.08 years. Mean score of body mass index (BMI) was 23.30 and most of the participants (46%) used opium in its traditional inhaled form. A higher concentration of morphine in blood was found in comparison with CSF (P < 0.001) in relation to the way of use. However, no statistically significant differences were found in relation to the type of addictive substance. No other association was found between the levels of morphine and the clinical characteristics of the patients. Moreover, results revealed no difference between hemodynamic-related data with blood and CSF level in opium-dependent patients.
Quantification of plasma and CSF morphine, both immediately before initiation of surgery and subsequently on recovery room, showed that although clinical efficacy of systemic morphine was poor in addicted patients, it had no effect on patients' hemodynamic variable and following complications after surgery.
伊朗人鸦片成瘾的患病率相当高。由于成瘾可能会改变内源性阿片系统，因此对于即将接受手术的阿片类成瘾伊朗患者，测定其血浆和脑脊液中吗啡的水平非常重要。
我们从50名有既定阿片类成瘾模式的志愿者身上采集了脑脊液和血浆样本。使用高效液相色谱法（HPLC）对样本进行分析。此外，在手术期间和术后10分钟间隔内记录恶心和呕吐的频率、基线心率（BHR）和收缩压（SBP）。
84%的参与者为男性，中位年龄为39.08岁。体重指数（BMI）的平均得分是23.30，大多数参与者（46%）使用传统吸入形式的鸦片。就使用方式而言，血液中吗啡的浓度高于脑脊液（P < 0.001）。然而，就成瘾物质类型而言，未发现统计学上的显著差异。在吗啡水平与患者临床特征之间未发现其他关联。此外，结果显示，阿片依赖患者的血液动力学相关数据与血液和脑脊液水平之间没有差异。
在手术开始前和随后在恢复室对血浆和脑脊液中的吗啡进行定量分析表明，虽然全身使用吗啡对成瘾患者的临床疗效较差，但它对患者的血液动力学变量和术后并发症没有影响。
