Qualitative measurement of opioid effects on pain and dyspnea: gender difference in the sensitivity.
Qualitative measurement of opioid effects on pain and dyspnea: gender difference in the sensitivity.
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DOI：
10.1186/s40981-020-00391-y
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发表时间：
2020-10-20
影响因子：
0.9
通讯作者：
Isono S
中科院分区：
文献类型：
--
作者：
Nozaki-Taguchi N;Hayashida T;Isono S
越来越多的患者来到手术室使用阿片类镇痛药。他们对阿片类药物作用的耐受程度不同，这对麻醉师在围手术期寻找安全有效的阿片类药物剂量提出了挑战。经检验的假设是，引入简单的措施将使我们能够定性地测量耐受性。测试阿片类药物对疼痛（镇痛）和呼吸困难感觉（缓解效果）的作用。根据术前镇痛药将患者分为三组：（1）对照组，不使用任何阿片类镇痛药；（2）弱阿片类药物；（3）强阿片类药物。在静脉注射芬太尼之前和之后 3 分钟两个点测量压痛阈值 (PPT) 和无呼吸感觉期 (NRSP)。共有 58 名患者（43 名对照者、9 名弱阿片类药物和 6 名强阿片类药物）患者入组。对照组患者静脉注射 2μg/kg 理想体重 (IBW) 芬太尼后，PPT 和 NRSP 显着升高（PPT：6.2 ± 2.1 N 至 9.2 ± 3.9 N，p < 0.0001，NRSP：17.8 ± 10.8 s 至 22.8 ± 18.7 s，p < 0.005，配对 t 检验）。然而，术前阿片类药物的使用虽然有趋势，但并未显示出阿片类药物作用的显着降低。由于参与人数不足，无法得出结论。对对照患者数据的进一步分析显示，两性对 PPT 和 NRSP 的敏感性以及芬太尼对 PPT 的影响存在显着差异。目前的数据显示了一种测量阿片类药物在两个维度上的作用的简单方法：疼痛和呼吸。尽管无法对阿片类药物使用者的耐受形成进行定性测量，但对照患者的数据显示，女性对疼痛和呼吸困难更敏感，但对阿片类药物的作用不太敏感。需要进一步的研究来证明这些性别差异是否具有临床相关性。 UMIN，UMIN 000011580。2013 年 8 月 27 日注册，https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000013352&language=J
An increasing number of patients come to the operating room in use of opioid analgesics. They have different levels of tolerance to opioid effects which challenge the anesthesiologists in search of safe and effective opioid dosing perioperatively. The tested hypothesis is that simple measures introduced will allow us to measure tolerance qualitatively. Opioid effects on pain (analgesia) and dyspnea sensations (relieving effect) are tested. Patients were allocated to three groups according to pre-operative analgesics: (1) control, without any opioid analgesics, (2) weak opioid, and (3) strong opioid. Pressure pain threshold (PPT) and no-respiratory sensation period (NRSP) were measured at two points: before and 3 min after intravenous fentanyl administration. A total of 58 (43 controls, 9 weak opioids, and 6 strong opioids) patients were enrolled. PPT and NRSP, after iv 2 μg/kg ideal body weight (IBW) fentanyl, were significantly elevated in the control patients (PPT: 6.2 ± 2.1 N to 9.2 ± 3.9 N, p < 0.0001, NRSP: 17.8 ± 10.8 s to 22.8 ± 18.7 s, p < 0.005, paired t test). However, preoperative opioid use, though with tendency, did not show a significant decrease of the opioid effect. Due to an insufficient number of participants, no conclusion could be drawn. Further analysis of the data from control patients showed a significant difference between the two sexes in sensitivity to PPT and NRSP, as well as fentanyl effect on PPT. Current data showed a simple method of measuring the opioid effect on two dimensions: pain and respiration. Though not able to show a qualitative measurement of tolerance formation in opioid-users, data from control patients showed females to be more sensitive to pain and dyspnea but is less sensitive to the opioid effect. Further studies are necessary to show whether these gender differences serve as clinical relevance. UMIN, UMIN 000011580. Registered 27 August 2013, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000013352&language=J
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影响因子：
4
作者：
Fillingim, RB;Ness, TJ;Staud, R
通讯作者：
Staud, R
影响因子：
7.4
作者：
Koltzenburg, Martin;Pokorny, Rolf;Richarz, Ute
通讯作者：
Richarz, Ute
影响因子：
7.4
作者：
Nishino, Takashi;Yashiro, Eiko;Ishikawa, Teruhiko
通讯作者：
Ishikawa, Teruhiko
影响因子：
6
作者：
Nishino, T;Sugimori, K;Ishikawa, T
通讯作者：
Ishikawa, T
DOI：
10.1164/rccm.201101-0005oc
发表时间：
2011-10-15
影响因子：
24.7
作者：
Banzett, Robert B.;Adams, Lewis;Schwartzstein, Richard M.
通讯作者：
Schwartzstein, Richard M.