Bromage P R, Camporesi E M, Durant P A, Nielsen C H
Anesthesiology. 1983 Mar;58(3):257-62. doi: 10.1097/00000542-198303000-00010.
The effects of epinephrine 1/200,000 as an adjuvant to epidural morphine were investigated in three healthy male volunteers, during 26-h observation sessions. Peak blood concentrations of morphine were 44 +/- 12.9 ng/ml after plain morphine and 13.7 +/- 6.7 ng/ml after epinephrine-morphine. Cutaneous hypalgesia was more intense, faster in onset, and longer in duration after epinephrine-morphine than after plain morphine, and analgesia to ice-water immersion of extremities lasted longer. Adverse side effects of pruritus, nausea, vomiting, and difficulty of micturition were also more intense after epinephrine-morphine, and respiratory sensitivity to CO2 was depressed more severely between 6 and 16 h. The results indicated that epinephrine 1/200,000 reduces vascular absorption of epidural morphine and intensifies all the manifestations of cord and brainstem uptake.
在三个健康男性志愿者身上，于26小时的观察期内，研究了1/200,000肾上腺素作为硬膜外吗啡佐剂的效果。单纯吗啡给药后吗啡的血药浓度峰值为44±12.9 ng/ml，肾上腺素-吗啡给药后为13.7±6.7 ng/ml。与单纯吗啡相比，肾上腺素-吗啡给药后皮肤痛觉减退更强烈、起效更快且持续时间更长，对四肢冰水浸泡的镇痛作用持续时间也更长。肾上腺素-吗啡给药后瘙痒、恶心、呕吐和排尿困难等不良反应也更强烈，且在6至16小时之间对二氧化碳的呼吸敏感性抑制更严重。结果表明，1/200,000肾上腺素可减少硬膜外吗啡的血管吸收，并增强脊髓和脑干摄取的所有表现。
