Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230061, PR China; Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University, Hefei 230022, PR China.
Department of Anesthesiology, The Third Affiliated Hospital of Anhui Medical University, Hefei 230022, PR China; Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230061, PR China.
Int J Cardiol. 2021 Jan 1;322:207-210. doi: 10.1016/j.ijcard.2020.08.064. Epub 2020 Aug 21.
When combined with morphine, nalbuphine not only does not affect the analgesic effect but also prevents opioid-induced side effects. The authors investigated whether nalbuphine interferes with morphine-induced cardioprotection in rats.
Anesthetized male Sprague-Dawley rats were randomly assigned to 1 of 4 treatment groups. Nalbuphine (NAL, 1 mg/kg) and morphine (MOR, 0.3 mg/kg) were administered 10 and 5 min prior to myocardial ischemia, respectively. Additionally, the NAL + MOR group received the combination of NAL and MOR prior to myocardial ischemia. An in vivo animal model was established by occluding the left anterior descending artery for 30 min and reperfusing it for 2 h. After 2 h of reperfusion, the infarcted area of heart was measured by Evans blue/triphenyl tetrazolium staining, and the levels of creatine kinase isoenzymes (CK-MB) in serum were detected by enzyme-linked immunosorbent assay.
Nalbuphine had no protective effect against the infarct area compared with the control treatment (NAL, 52.5 ± 5% versus CON, 52.6 ± 4%; *P < 0.01), and the infarct size-sparing effects of morphine were not affected by nalbuphine (NAL + MOR, 42.6 ± 7% versus MOR, 40.4 ± 3%; P > 0.05). The nalbuphine group did not show a change the levels of serum CK-MB compared with the control group, and nalbuphine did not affect the levels of serum CK-MB in the MOR group.
Nalbuphine does not interfere with the cardioprotective effect of morphine in vivo. Therefore, nalbuphine could be safely used or combined with morphine in patients with acute myocardial infarction.
纳布啡与吗啡联合使用不仅不影响其镇痛效果，还可预防阿片类药物引起的副作用。作者研究了纳布啡是否会干扰吗啡诱导的大鼠心肌保护作用。
将麻醉的雄性 Sprague-Dawley 大鼠随机分为 4 个治疗组。纳布啡（NAL，1 mg/kg）和吗啡（MOR，0.3 mg/kg）分别在缺血前 10 和 5 分钟给予。此外，NAL+MOR 组在缺血前给予 NAL 和 MOR 的组合。通过结扎左前降支 30 分钟和再灌注 2 小时建立体内动物模型。再灌注 2 小时后，通过 Evans 蓝/三苯基四氮唑染色测量心脏梗死区，通过酶联免疫吸附试验检测血清肌酸激酶同工酶（CK-MB）的水平。
与对照组相比，纳布啡对梗死面积没有保护作用（NAL，52.5±5%vs CON，52.6±4%；*P<0.01），而吗啡的梗死面积节省作用不受纳布啡影响（NAL+MOR，42.6±7%vs MOR，40.4±3%；P>0.05）。与对照组相比，纳布啡组血清 CK-MB 水平没有变化，纳布啡也没有影响 MOR 组血清 CK-MB 的水平。
纳布啡不干扰体内吗啡的心肌保护作用。因此，纳布啡可在急性心肌梗死患者中安全使用或与吗啡联合使用。
