INTRATHECAL FENTANYL DEPRESSES NOCICEPTIVE FLEXION REFLEXES IN PATIENTS WITH CHRONIC PAIN
INTRATHECAL FENTANYL DEPRESSES NOCICEPTIVE FLEXION REFLEXES IN PATIENTS WITH CHRONIC PAIN
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DOI：
10.1097/00000542-198902000-00008
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发表时间：
1989-02-01
期刊：
影响因子：
8.8
通讯作者：
LITTLE, J
中科院分区：
文献类型：
--
作者：
CHABAL, C;JACOBSON, L;LITTLE, J
为了研究椎管内阿片类药物在疼痛感知和调节中的选择性作用，7例慢性髋关节或背部疼痛患者和1例C-6四肢瘫痪患者接受了25 .mu的注射。G的鞘内芬太尼。腰椎鞘内芬太尼对报告的疼痛、痛觉性屈肌戒断反射、单突触运动弧（h反射）和脊柱上效应（如缩小、恶心、呼吸抑制）的影响进行了评估。在8名受试者中，有5名在15分钟内屈肌撤回反射完全消失。在其他实验中，反射明显低于控制值。报告疼痛的减少与屈肌反射的减少平行，h反射保持不变，未观察到棘上副作用。观察到的这些选择性变化很可能来自芬太尼在脊髓水平调节伤害感觉的孤立效应。
To investigate the selective role of intraspinal opioids on the perception and modulation of pain, seven subjects with chronic hip or back pain and one subject with C-6 quadriplegia received 25 .mu.g of intrathecal fentanyl. The effect of lumbar intrathecal fentanyl on reported pain, nociceptive flexor withdrawal reflexes, a monosynaptic motor arc (H-reflex), and supraspinal effects such as miosis, nausea, respiratory depression was evaluated. In five of eight subjects the flexor withdrawal reflex was completely abolished within 15 min. In the others the reflex was significantly depressed from control values. Decreases in reported pain paralleled the decrease in the flexor reflex, H-reflexes remained unchanged, and no supraspinal side effects were observed. It is likely that these selective changes observed were from the isolated effect of fentanyl modulating nociception at the spinal cord level.