Morphine responses and experimental pain: Sex differences in side effects and cardiovascular responses but not analgesia
Morphine responses and experimental pain: Sex differences in side effects and cardiovascular responses but not analgesia
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DOI：
10.1016/j.jpain.2004.11.005
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发表时间：
2005-02-01
期刊：
影响因子：
4
通讯作者：
Staud, R
中科院分区：
文献类型：
--
作者：
Fillingim, RB;Ness, TJ;Staud, R
已经报道了对g阿片激动剂的镇痛反应的性别差异，尽管这些差异的方向在不同的研究中有所不同。为了进一步描述对μ阿片类药物反应的性别差异，通过使用3种实验性疼痛模型（热痛、压迫痛和缺血性疼痛），在健康女性（n = 61）和男性（n = 39）中测定静脉注射吗啡（0.08 mg/kg）的镇痛作用。在吗啡和生理盐水双盲给药之前和之后进行每个疼痛程序，其以平衡顺序在不同的日子发生。虽然吗啡产生显着的镇痛效果，所有的疼痛刺激，吗啡镇痛没有显着的性别差异。然而，吗啡减弱了男性对缺血性疼痛任务的心血管反应，但对女性没有影响，女性报告的药物相关不良反应明显多于男性。这些发现与最近的一些临床和实验结果形成对比，这些结果表明与男性相比，女性对μ阿片类药物的镇痛反应更强，尽管数据表明吗啡的非镇痛作用存在性别差异。这些结果表明，对吗啡的反应的性别差异可能取决于疼痛模型和/或药物剂量以及具体的终点assessed.Perspective：本研究探讨吗啡反应的妇女和男子通过使用实验室疼痛措施。结果表明，镇痛没有性别差异，但女性报告更大的副作用，吗啡衰减心血管反应更强烈的男性比女性。这些结果增加了关于阿片类药物反应的性别差异的文献。(C)2005年由美国疼痛学会主办。
Sex differences in analgesic responses to g opioid agonists have been reported, although the direction of these differences varies across studies. To further characterize sex differences in responses to mu opioids, the analgesic effects of intravenous morphine (0.08 mg/kg) were determined in healthy women (n = 61) and men (n = 39) by using 3 experimental pain models, heat pain, pressure pain, and ischemic pain. Each pain procedure was conducted before and after double-blind administration of both morphine and saline, which occurred on separate days in counterbalanced order. Although morphine produced significant analgesic effects for all pain stimuli, no significant sex differences in morphine analgesia emerged. However, morphine attenuated cardiovascular reactivity to the ischemic pain task in men but not women, and women reported significantly more drug-related adverse effects than men. These findings are in contrast with some recent clinical and experimental results suggesting more robust analgesic response to mu opioids among women compared to men, although the data indicate that sex differences in non-analgesic effects of morphine were present. These results suggest that sex differences in responses to morphine might depend on the pain model and/or drug dose as well as the specific end point assessed.Perspective: This study examines morphine responses in women and men by using laboratory pain measures. The results indicate no sex differences in analgesia, but women reported greater side effects, and morphine attenuated cardiovascular responses more strongly among men than women. These results add to the literature regarding sex differences in response to opioids. (C) 2005 by the American Pain Society.