Ronald A L, Docherty D, Broom J, Chambers W A
Dept. of Anesthesia, Aberdeen Royal Infirmary, Scotland.
Anesth Analg. 1993 Apr;76(4):778-82. doi: 10.1213/00000539-199304000-00016.
Morphine absorption from subcutaneous and intramuscular injection sites is dependent on local skin and muscle blood flow. Normally, drug absorption from intramuscular and subcutaneous injections at the same anatomical site is comparable, but spinal anesthesia alters muscle and skin blood flow in the blocked area. This study measured morphine absorption from pairs of intramuscular and subcutaneous injection sites at vastus lateralis and deltoid following a single dose of morphine sulfate in the presence of spinal anesthesia. Differences between the maximum concentration achieved after injection (Cmax) and the time at which this occurred (Tmax) were not significant when absorption for each "same-site" pair of injections was compared, but Tmax after intramuscular injection at vastus lateralis was significantly longer than that observed following either intramuscular or subcutaneous injection at the deltoid (P < 0.05 for both comparisons). Cmax/Tmax ratios and the area under concentration time curve (AUC) also were analyzed, but there were no statistically significant differences among any of the four groups.
皮下和肌肉注射部位的吗啡吸收取决于局部皮肤和肌肉血流。通常，在相同解剖部位进行肌肉注射和皮下注射时，药物吸收情况相当，但脊髓麻醉会改变阻滞区域的肌肉和皮肤血流。本研究测量了在脊髓麻醉情况下，单次注射硫酸吗啡后，股外侧肌和三角肌处肌肉注射部位与皮下注射部位成对组合的吗啡吸收情况。当比较每对“同部位”注射后的吸收情况时，注射后达到的最大浓度（Cmax）及其出现时间（Tmax）之间的差异不显著，但股外侧肌肌肉注射后的Tmax显著长于三角肌处肌肉注射或皮下注射后的Tmax（两种比较的P均<0.05）。还分析了Cmax/Tmax比值和浓度-时间曲线下面积（AUC），但四组之间均无统计学显著差异。
