硬膜外给予妊娠母羊后,中枢神经系统和脑脊液中的羟考酮浓度。

Oxycodone concentrations in the central nervous system and cerebrospinal fluid after epidural administration to the pregnant ewe.

机构信息

School of Medicine, University of Eastern Finland, Kuopio, Finland.

Admescope Ltd, Oulu, Finland.

出版信息

Basic Clin Pharmacol Toxicol. 2019 Nov;125(5):430-438. doi: 10.1111/bcpt.13276. Epub 2019 Jul 11.

Abstract

The main sites of the analgesic action of oxycodone are the brain and spinal cord. The present study describes the concentrations of oxycodone and its metabolites in the brain and spinal cord after epidural administration to the ewe. Twenty pregnant ewes undergoing laparotomy were randomized into two groups to receive epidural oxycodone: infusion group (n = 10, 0.1 mg·kg bolus followed by continuous infusion of 0.05 mg·kg ·h for five days) or repeated boluses group (n = 10, 0.2 + 2x0.1 mg·kg bolus followed by a 0.2 mg·kg bolus every 12 hours for five days). After five days of oxycodone administration, arterial blood samples were collected, the sheep were killed, and a CSF sample and tissue samples from the cortex, thalamus, cerebellum and spinal cord were obtained for the quantification of oxycodone and its main metabolites. The median plasma and CSF concentrations of oxycodone were 9.0 and 14.2 ng·mL after infusion and 0.4 and 1.1 ng·mL after repeated boluses. In the infusion group, the cortex, thalamus and cerebellum oxycodone concentrations were 4-8 times higher and in the spinal cord 1310 times higher than in plasma. In the repeated boluses group, brain tissue concentrations were similar in the three areas, and in the spinal cord were 720 times higher than in plasma. Oxymorphone was the main metabolite detected, which accumulated in the brain and spinal cord tissue. In conclusion, first, accumulation of oxycodone and oxymorphone in the CNS was observed, and second, high spinal cord concentrations suggest that epidural oxycodone may provide segmental analgesia.

摘要

羟考酮的主要镇痛作用部位是大脑和脊髓。本研究描述了硬膜外给予绵羊羟考酮后,其在大脑和脊髓中的浓度。20 只接受剖腹手术的妊娠母羊随机分为两组,接受硬膜外羟考酮:输注组(n=10,0.1mg·kg 负荷剂量后连续输注 0.05mg·kg·h 持续 5 天)或重复推注组(n=10,0.2+2x0.1mg·kg 负荷剂量后每 12 小时给予 0.2mg·kg 推注持续 5 天)。在给予羟考酮 5 天后,采集动脉血样,处死绵羊,并采集脑脊液样本和来自皮质、丘脑、小脑和脊髓的组织样本,以定量羟考酮及其主要代谢物。输注后羟考酮的中位血浆和脑脊液浓度分别为 9.0 和 14.2ng·mL,重复推注后分别为 0.4 和 1.1ng·mL。在输注组中,皮质、丘脑和小脑的羟考酮浓度是血浆的 4-8 倍,而在脊髓中是血浆的 1310 倍。在重复推注组中,三个区域的脑组织浓度相似,而在脊髓中是血浆的 720 倍。氧吗啡酮是检测到的主要代谢物,在脑和脊髓组织中积累。总之,首先观察到羟考酮和氧吗啡酮在中枢神经系统中的积累,其次,脊髓中的高浓度表明硬膜外羟考酮可能提供节段性镇痛。

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