Mori T
Nihon Sanka Fujinka Gakkai Zasshi. 1982 Oct;34(10):1707-16.
Epidural micro-injection of morphine hydrochloride is very useful for the postoperative analgesic method. In this study, we investigated the relationship between appearance of amelioration of pain and the plasma prolactin (PRL), growth hormone (GH) and ACTH levels following epidural morphine. The plasma PRL levels significantly elevated with surgical stress. Following epidural morphine, the plasma PRL levels significantly decreased in the effective cases, and significantly increased in the ineffective cases. Following epidural morphine, the plasma ACTH levels significantly decreased in the effective cases, and insignificantly increased in the ineffective cases. The duration to onset of amelioration of pain was prolonged with intravenous injections of metoclopramide (MCP) before epidural morphine. We concluded that patterns of PRL and ACTH releases following epidural morphine were correspondent with the analgesic effect, and that appearance of amelioration of pain following epidural morphine may depend upon the dopaminergic mechanism.
硬膜外微量注射盐酸吗啡是一种非常有用的术后镇痛方法。在本研究中，我们调查了硬膜外注射吗啡后疼痛缓解的出现与血浆催乳素（PRL）、生长激素（GH）和促肾上腺皮质激素（ACTH）水平之间的关系。手术应激使血浆PRL水平显著升高。硬膜外注射吗啡后，有效病例的血浆PRL水平显著下降，无效病例则显著升高。硬膜外注射吗啡后，有效病例的血浆ACTH水平显著下降，无效病例则无显著升高。在硬膜外注射吗啡前静脉注射甲氧氯普胺（MCP）可延长疼痛缓解开始的时间。我们得出结论，硬膜外注射吗啡后PRL和ACTH的释放模式与镇痛效果相对应，硬膜外注射吗啡后疼痛缓解的出现可能取决于多巴胺能机制。
