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吗啡对有害刺激引起的心率反应的影响:与氟烷和纳洛酮的相互作用。

Effect of morphine on the heart rate response to noxious stimulation: interaction with halothane and naloxone.

作者信息

Kissin Igor, Kerr Reid C, Smith Richard L

机构信息

Department of Anesthesiology, School of Medicine, University of Alabama in Birmingham, University Station, Birmingham, AL 35294 U.S.A.

出版信息

Pain. 1984 Apr;18(4):351-358. doi: 10.1016/0304-3959(84)90047-2.

Abstract

The effect of morphine on the heart rate increase, in response to noxious somatic stimulation, was studied in 125 rat experiments. It was found that halothane, in a subanesthetic concentration of 0.3 vol%, profoundly weakened the effect of morphine on the heart rate response. As a result, the morphine ED50 value for blockade of the heart rate response was increased from 5.9 to 46.1 mg/kg (P less than 0.001). Naloxone in a dose of 0.05 mg/kg increased the morphine ED50 value for blockade of the heart rate response 11-fold (morphine was administered without halothane). However, the same dose of naloxone did not change the morphine ED50 value obtained with combined administration of morphine and halothane. An increase in the naloxone dosage (up to 1 mg/kg) was necessary to demonstrate the naloxone antagonistic effect (8-fold increase in the morphine ED50 value) when morphine was given with halothane. It has been suggested that the effect of morphine on the heart rate response to noxious stimulation results primarily from the activation of inhibitory control mechanisms concerned with this response (indirect effect). Halothane depresses the inhibitory control mechanisms and, therefore, weakens the effect of morphine. A significant increase in doses of morphine is needed to provide the direct antinociceptive effect.

摘要

在125次大鼠实验中,研究了吗啡对因有害躯体刺激而导致的心率增加的影响。发现0.3%(体积分数)的亚麻醉浓度氟烷能显著削弱吗啡对心率反应的影响。结果,吗啡阻断心率反应的半数有效剂量(ED50)值从5.9毫克/千克增至46.1毫克/千克(P<0.001)。0.05毫克/千克剂量的纳洛酮使无氟烷时吗啡阻断心率反应的ED50值增加了11倍。然而,相同剂量的纳洛酮并未改变吗啡与氟烷联合使用时的ED50值。当吗啡与氟烷合用时,需增加纳洛酮剂量(高达1毫克/千克)才能显示出纳洛酮的拮抗作用(吗啡ED50值增加8倍)。有人提出,吗啡对有害刺激心率反应的作用主要源于激活与该反应相关的抑制性控制机制(间接作用)。氟烷会抑制这些抑制性控制机制,因此会削弱吗啡的作用。需要大幅增加吗啡剂量才能产生直接的镇痛作用。

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