Hasan S U, Lee D S, Gibson D A, Nowaczyk B J, Cates D B, Sitar D S, Pinsky C, Rigatto H
Department of Pediatrics, University of Manitoba, Canada.
J Appl Physiol (1985). 1988 May;64(5):2058-65. doi: 10.1152/jappl.1988.64.5.2058.
To define the dose response of apnea and breathing to morphine we studied 12 fetuses at 116-141 days of gestation using our window technique. We instrumented the fetus to record electrocortical activity (ECoG), eye movements (EOG), diaphragmatic activity (integral of EMGdi), heart rate, carotid blood pressure, and amniotic pressure. Saline and morphine in doses of 0.03, 0.1, 0.5, 1, and 3 mg/kg were injected in random order in the jugular vein of the fetus during low-voltage ECoG. Fetuses were videotaped for evaluation of fetal behavior. We found 1) that saline did not elicit a response; 2) apnea, associated with a change from low- to high-voltage ECoG, increased from 2.2 +/- 1.5 (SE) min in two fetuses at a dose of 0.03 mg to 20 +/- 6.3 min in seven fetuses at 3 mg/kg (P less than 0.005); 3) the length of the breathing responses, associated with a change from high- to low-voltage ECoG, were 15 +/- 1.8 and 135.9 +/- 18.1 min (P less than 0.0005); 4) integral of EMGdi X frequency, an index equivalent to minute ventilation, increased from 1,763 +/- 317 arbitrary units to 10,658 +/- 1,843 at 1.0 mg/kg and then decreased to 7,997 +/- 1,335 at 3.0 mg/kg. These changes were related to a steady increase in integral of EMGdi, whereas frequency decreased at 3 mg/kg. There was an increase in breathing response to morphine plasma concentrations or morphine doses.(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定呼吸暂停和呼吸对吗啡的剂量反应,我们使用窗口技术研究了12例妊娠116 - 141天的胎儿。我们对胎儿进行仪器监测以记录皮层电图(ECoG)、眼动(EOG)、膈肌活动(EMGdi积分)、心率、颈动脉血压和羊膜压力。在低电压ECoG期间,将生理盐水和剂量为0.03、0.1、0.5、1和3mg/kg的吗啡以随机顺序注入胎儿颈静脉。对胎儿进行录像以评估胎儿行为。我们发现:1)生理盐水未引发反应;2)与低电压ECoG转变为高电压ECoG相关的呼吸暂停,在剂量为0.03mg时,2例胎儿的呼吸暂停时间为2.2±1.5(SE)分钟,在3mg/kg时,7例胎儿的呼吸暂停时间增加至20±6.3分钟(P<0.005);3)与高电压ECoG转变为低电压ECoG相关的呼吸反应时长分别为15±1.8分钟和135.9±18.1分钟(P<0.0005);4)EMGdi×频率积分(相当于分钟通气量的指标)在1.0mg/kg时从1763±317任意单位增加至10658±1843,然后在3.0mg/kg时降至7997±1335。这些变化与EMGdi积分的稳步增加有关,而频率在3mg/kg时降低。呼吸对吗啡血浆浓度或吗啡剂量有增加反应。(摘要截短于250字)