Shibata Y, Nimura Y, Yasui A, Miyachi M, Shimada Y
First Department of Surgery, Nagoya University School of Medicine, Japan.
Hepatogastroenterology. 1994 Dec;41(6):559-63.
The early postoperative recovery of intestinal motility and the response of motility to epidural morphine were investigated in 20 patients. Periodic motor activities in the jejunum were recovered within 32 hours in all cases. The length of these cycles increased gradually from the 1st (23.2 min) to the 4th (41.7 min) postoperative day. Morphine and lignocaine were given through an epidural catheter. Morphine induced premature migrating motor complexes (MMC) in all cases, whereas lidocaine failed to evoke this response in every case. The mean duration (19.8 min) and maximal amplitude (62.8 mmHg) of the burst activities induced by morphine were significantly longer and higher than those occurring spontaneously (7.7 min and 35.6 mmHg, respectively). The intervals between the induced and the subsequent spontaneous contractions were the same as the intervals between spontaneous contractions. These observations indicate that epidural morphine induced premature MMC without interrupting recovery patterns from postoperative gastrointestinal paralysis.
对20例患者术后早期肠道动力恢复情况以及动力对硬膜外吗啡的反应进行了研究。所有病例空肠的周期性运动活动均在32小时内恢复。这些周期的时长从术后第1天(23.2分钟)到第4天(41.7分钟)逐渐增加。通过硬膜外导管给予吗啡和利多卡因。吗啡在所有病例中均诱发了提前出现的移行性运动复合波(MMC),而利多卡因并非在每个病例中都能引发这种反应。吗啡诱发的爆发活动的平均持续时间(19.8分钟)和最大幅度(62.8 mmHg)显著长于和高于自发出现的情况(分别为7.7分钟和35.6 mmHg)。诱发收缩与随后自发收缩之间的间隔与自发收缩之间的间隔相同。这些观察结果表明,硬膜外吗啡诱发了提前出现的MMC,且未中断术后胃肠麻痹的恢复模式。