Brennum Jannick, Arendt-Nielsen Lars, Horn Allan, Secher Niels H, Jensen Troels S
Laboratory of Sensory Physiology, Department of Neurology, Gentofte Hospital, DK-2900 HellerupDenmark Department of Medical Informatics, Aalborg University, DK-9200 AalborgDenmark Department of Anaesthesia, Rigshospitalet, DK-2100 København Ø Denmark Department of Neurology, Aarhus University Hospital, DK-8000 Aarhus C Denmark.
Pain. 1993 Jan;52(1):75-83. doi: 10.1016/0304-3959(93)90117-8.
In a double-blind placebo-controlled cross-over study the effects of epidural morphine (4 mg) on somatosensory functions were investigated in 10 healthy volunteers. Detection, pain detection and pain tolerance thresholds to thermal, mechanical and electrical stimuli as well as magnitude rating of short-lasting stimuli of the same modalities were monitored before and for 10 h after epidural administration of 4 mg of morphine or saline. Epidural morphine induced a naloxone-reversible (0.1 mg/kg, i.v.) increase in pain detection threshold to heat and mechanical stimuli and in pain tolerance threshold to heat, mechanical and electrical stimuli. Morphine induced a more pronounced increase in the pain tolerance than in the pain detection threshold. Magnitude rating of short-lasting radiant heat (argon laser) stimuli were reduced by epidural morphine in comparison to placebo while there was no significant difference between the effects of morphine and placebo on magnitude rating of short-lasting mechanical and electrical stimuli. The warm detection threshold was increased (naloxone reversible) by morphine. Segmental distribution of pruritus was reported by 7 subjects following epidural morphine which was replaced by a short-lasting burning sensation following naloxone administration. Naloxone (0.1 mg/kg) preceeded by placebo did not change somatosensory functions. These results indicate that the somatosensory effect of epidural morphine is dependent on the types of afferent fibres activated as well as on the duration and intensity of the stimulus.
在一项双盲、安慰剂对照的交叉研究中，对10名健康志愿者研究了硬膜外注射吗啡（4毫克）对躯体感觉功能的影响。在硬膜外注射4毫克吗啡或生理盐水之前及之后10小时，监测对热、机械和电刺激的检测、疼痛检测及疼痛耐受阈值，以及相同刺激方式的短持续时间刺激的强度评定。硬膜外注射吗啡使对热和机械刺激的疼痛检测阈值以及对热、机械和电刺激的疼痛耐受阈值出现纳洛酮可逆性（静脉注射0.1毫克/千克）升高。吗啡使疼痛耐受阈值的升高比疼痛检测阈值更为显著。与安慰剂相比，硬膜外注射吗啡使短持续时间辐射热（氩激光）刺激的强度评定降低，而吗啡和安慰剂对短持续时间机械和电刺激强度评定的影响无显著差异。吗啡使温觉检测阈值升高（纳洛酮可逆）。7名受试者报告硬膜外注射吗啡后出现瘙痒的节段性分布，注射纳洛酮后被短暂的烧灼感所取代。在给予安慰剂后注射纳洛酮（0.1毫克/千克）未改变躯体感觉功能。这些结果表明，硬膜外注射吗啡的躯体感觉效应取决于被激活的传入纤维类型以及刺激的持续时间和强度。
