Willer Jean Claude, Bergeret Sabine, De Broucker Thomas, Gaudy Jean-Henri
Lab. Clinical Neurophysiology, Fac. Méd, Saint-Antoine, 75571 Paris Cedex 12 France Dept. of Anesthesiology, Hôpital Rothschild, 75012 ParisFrance.
Pain. 1988 Jan;32(1):9-14. doi: 10.1016/0304-3959(88)90017-6.
In order to determine the selectivity of the antinociceptive effect of epidural morphine, the electrophysiological features of a monosynaptic reflex were investigated before and after epidural morphine (2-3 mg) required for pain relief, in 4 patients suffering from postoperative pain. The reflex tested was the H reflex from the soleus muscle. Not only the classical Hmax/Mmax ratio, but also the threshold and the slope of the rising phase of the recruitment curve of H and M responses were analyzed. It was found that epidural morphine did not change significantly any of these parameters, at least during the 60 min post-injection period. By contrast, as usually observed clinically, epidural morphine produced an onset of pain relief by the 25th-30th min following injection. These data support the hypothesis that epidural morphine produced a 'selective spinal analgesia in man.'
为了确定硬膜外吗啡镇痛作用的选择性，对4例术后疼痛患者在给予缓解疼痛所需的硬膜外吗啡（2 - 3毫克）前后，研究了单突触反射的电生理特征。所测试的反射是比目鱼肌的H反射。不仅分析了经典的Hmax/Mmax比值，还分析了H和M反应募集曲线上升期的阈值和斜率。结果发现，至少在注射后60分钟内，硬膜外吗啡并未使这些参数中的任何一个发生显著变化。相比之下，正如临床上通常观察到的那样，硬膜外吗啡在注射后第25 - 30分钟开始产生疼痛缓解。这些数据支持了硬膜外吗啡在人体产生“选择性脊髓镇痛”这一假说。
