Ikeda T, Kurz A, Sessler D I, Go J, Kurz M, Belani K, Larson M, Bjorksten A R, Dechert M, Christensen R
Department of Anesthesia, University of California, San Francisco 94143-0648, USA.
Ann N Y Acad Sci. 1997 Mar 15;813:792-8. doi: 10.1111/j.1749-6632.1997.tb51783.x.
In summary, both mu-receptor and combined mu/kappa-receptor opioids impair thermoregulatory control. Alfentanil, a pure mu-receptor agonist slightly increased the thresholds for sweating and markedly decreased the thresholds for vasoconstriction and shivering. However, the vasoconstriction-to-shivering range remained normal during alfentanil administration as it does during general anesthesia. Meperidine, a combined mu- and kappa-receptor agonist, also slightly increased the threshold for sweating and reduced the thresholds for vasoconstriction. However, meperidine reduced the shivering threshold twice as much as the vasoconstriction threshold, thus significantly increasing the vasoconstriction-to-shivering range. Furthermore, shivering during meperidine administration, once triggered, was of low intensity suggesting that the drug also decreased the gain of shivering. The special antishivering action of meperidine appears to result, at least in part, from its kappa-receptor activity.
总之，μ受体和μ/κ受体联合作用的阿片类药物均会损害体温调节控制。阿芬太尼，一种纯μ受体激动剂，会使出汗阈值略有升高，并显著降低血管收缩和寒战阈值。然而，在使用阿芬太尼期间，血管收缩至寒战的范围仍保持正常，就像在全身麻醉期间一样。哌替啶，一种μ和κ受体联合激动剂，也会使出汗阈值略有升高，并降低血管收缩阈值。然而，哌替啶使寒战阈值降低的幅度是血管收缩阈值的两倍，从而显著增加了血管收缩至寒战的范围。此外，在使用哌替啶期间，一旦引发寒战，其强度较低，这表明该药物还降低了寒战的增益。哌替啶的特殊抗寒战作用似乎至少部分源于其κ受体活性。
