Siegel S
J Comp Physiol Psychol. 1975 Jul;89(5):498-506. doi: 10.1037/h0077058.
It is proposed that the direct analgesic effect of morphine becomes attenuated over the course of successive administrations of the narcotic by a conditioned, compensatory, hyperalgesic response elicited by the administration procedure, the net result being analgesic tolerance. Using the "hot plate" analgesia assessment situation with rats, this conditioning view of tolerance is supported by several findings: (a) It is necessary to have reliable environmental cues predicting the systemic effects of morphine if tolerance is to be observed, (b) a hyperalgesic conditioned response may be observed in morphine-tolerant subjects when drug administration cues are followed by a placebo, and (c) merely by repeatedly presenting environmental cues previously associated with morphine (but now presented with a placebo), morphine tolerance can be extinguished.
有人提出,吗啡的直接镇痛作用会在连续给予该麻醉药的过程中减弱,这是由给药程序引发的一种条件性、代偿性、痛觉过敏反应所致,最终结果是产生镇痛耐受性。使用大鼠的“热板”镇痛评估情境,耐受性的这种条件作用观点得到了多项研究结果的支持:(a) 如果要观察到耐受性,就必须有可靠的环境线索来预测吗啡的全身效应;(b) 当给药线索后接安慰剂时,在吗啡耐受的受试者中可能会观察到痛觉过敏的条件反应;(c) 仅仅通过反复呈现先前与吗啡相关的环境线索(但现在与安慰剂一起呈现),吗啡耐受性就可以消除。