Sear J, Moore A, Hunniset A, Baldwin D, Allen M, Hand C, McQuay H, Morris P
Anesth Analg. 1985 Nov;64(11):1065-70.
Morphine plasma concentrations were determined in six patients receiving kidney transplants from living-related donors, and nine patients receiving kidney transplants from cadavers. The total cold ischemic time was about 2 hr for kidneys from living-related donors and 14 hr for those from cadavers. After an intravenous bolus dose of morphine, plasma morphine concentrations decreased to a plateau that lasted for several hours; morphine elimination resumed when the transplanted kidney began to clear creatinine. The duration of the total cold ischemic time was significantly related to both the duration of the plateau in morphine concentration (P = 0.008) and the first postoperative day creatinine clearance (P = 0.021). Morphine elimination half-life after the plateau was related to first postoperative day creatinine clearance (P less than 0.001). It was concluded that morphine elimination depended upon intact renal function.
测定了6例接受亲属活体供肾移植患者和9例接受尸体供肾移植患者的吗啡血浆浓度。亲属活体供肾的总冷缺血时间约为2小时，尸体供肾的总冷缺血时间约为14小时。静脉注射一剂吗啡后，血浆吗啡浓度降至一个持续数小时的平台期；当移植肾开始清除肌酐时，吗啡消除恢复。总冷缺血时间与吗啡浓度平台期的持续时间（P = 0.008）和术后第1天的肌酐清除率均显著相关（P = 0.021）。平台期后的吗啡消除半衰期与术后第1天的肌酐清除率相关（P < 0.001）。得出的结论是，吗啡的消除依赖于完整的肾功能。
