Saito Y, Kaneko M, Kirihara Y, Sakura S, Kosaka Y
Department of Anesthesiology, Shimane Medical University, Izumo, Japan.
Anesth Analg. 1998 Dec;87(6):1340-5.
A continuous epidural infusion of morphine may cause a complicated tolerance to develop, depending on the spinal and supraspinal sites. We designed this study to clarify the characteristics of the tolerance to somatic and visceral antinociception after epidural morphine infusion. Rats received epidural infusion of morphine at the rates of 50 or 100 microg kg(-1) h(-1), or isotonic sodium chloride solution for 7 days. The tail-flick (TF) test and colorectal distension (CD) test were used to measure the somatic and visceral antinociceptive effects, respectively. Nociceptive tests were performed on Days 1, 2, 3, 4, and 7. After 7 days, time-response curves after epidural morphine (10 microg) or intraperitoneal morphine (3 mg) challenge tests were conducted to assess the magnitude of tolerance. Epidurally infused morphine significantly increased percent maximal possible effects (%MPEs) (P < 0.05) in both the TF and CD tests, depending on the concentration of morphine. In the epidural morphine challenge test, increases in %MPEs were significantly attenuated (P < 0.05) in the morphine-infused group compared with the isotonic sodium chloride solution-infused group. The increases in %MPEs in the intraperitoneal challenge test were also attenuated in the morphine-infused group. We conclude that morphine tolerance to both somatic and visceral antinociception develops rapidly during epidural infusion and is based on the development of tolerance at the systemic, as well as the epidural, level.
A continuous epidural infusion of morphine rapidly induces tolerance to visceral and somatic antinociception in rats. This development is based on the development of tolerance at the systemic, as well as the epidural, level.
硬膜外持续输注吗啡可能会导致复杂的耐受性,这取决于脊髓和脊髓上的部位。我们设计了这项研究,以阐明硬膜外输注吗啡后对躯体和内脏抗伤害感受耐受性的特征。大鼠以50或100微克/千克(-1)小时(-1)的速率接受硬膜外吗啡输注,或接受等渗氯化钠溶液输注7天。分别使用甩尾(TF)试验和结直肠扩张(CD)试验来测量躯体和内脏抗伤害感受作用。在第1、2、3、4和7天进行伤害感受测试。7天后,进行硬膜外吗啡(10微克)或腹腔注射吗啡(3毫克)激发试验后的时间-反应曲线,以评估耐受性的程度。硬膜外输注的吗啡根据吗啡浓度在TF和CD试验中均显著增加最大可能效应百分比(%MPEs)(P < 0.05)。在硬膜外吗啡激发试验中,与输注等渗氯化钠溶液的组相比,吗啡输注组的%MPEs增加显著减弱(P < 0.05)。腹腔激发试验中吗啡输注组的%MPEs增加也减弱。我们得出结论,在硬膜外输注期间,吗啡对躯体和内脏抗伤害感受的耐受性迅速发展,并且基于全身以及硬膜外水平耐受性的发展。
硬膜外持续输注吗啡会迅速诱导大鼠对内脏和躯体抗伤害感受产生耐受性。这种发展基于全身以及硬膜外水平耐受性的发展。