Effect of morphine, prostigmine, pethidine, and probanthine on the human colon in diverticulosis studied by intraluminal pressure recording and cineradiography
Effect of morphine, prostigmine, pethidine, and probanthine on the human colon in diverticulosis studied by intraluminal pressure recording and cineradiography
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通过腔内压力记录和电影放射线摄影研究吗啡、前斯的明、哌替啶和丙班丁对憩室病中人结肠的影响
作者：
N. S. Painter;S. Truelove;Ardran Gm;M. Tuckey
编辑概要：先前的研究表明吗啡可引起乙状结肠内高压，在结肠憩室病中，这种作用在实际存在憩室的节段中被夸大了。因此，有一个初步证据的情况下，质疑给予吗啡与憩室病人的智慧。在本研究中，采用放射线电影摄影结合腔内压力记录来研究吗啡和其他药物给药后结肠憩室的行为。吗啡引起的乙状结肠内高压常伴有邻近憩室的扩张，有时扩张至极端程度。虽然憩室的括约肌在吗啡的作用下可以关闭，但它们并不是保持关闭，而是间歇性地打开，并允许结肠内容物喷入憩室。在急性憩室炎中使用吗啡可能会导致憩室炎性破裂。吗啡的这些作用可以通过静脉注射抗胆碱能药物普罗本辛来消除。止痛药哌替啶（杜冷丁）没有吗啡的副作用，因此建议在缓解急性憩室炎疼痛时，首选哌替啶。
EDITORIALSYNOPSISA previous study hasshownthatmorphine causesthegeneration ofhigh intrasigmoid pressures.Indiverticulosis ofthecolon, this effect isexaggerated inthose segments actually bearing diverticula. Thereistherefore a primafacie caseforquestioning thewisdomof giving morphine topatients withdiverticulosis. Inthepresent investigation, cineradiography was usedinconjunction withintraluminal pressurerecording tostudythebehaviour ofcolonic diverticula after theadministration ofmorphine andother drugs. Highintrasigmoid pressures evoked bymorphine areshowntobeaccompanied bydistension ofneighbouring diverticula, sometimes toanextrelne degree. Although thenecks ofthediverticula may shutunder theinfluence ofmorphine, theydonotremain closed butopen intermittently andallow colonic contents tobe squirted intothediverticula. Itappearspossible thattheuseofmorphine inacutediverticulitis may predispose torupture ofinflamed diverticula. Theseeffects ofmorphine can beabolished byan intravenous injection oftheanticholinergic agent,probanthine. Theanalgesic drug, pethidine (demerol), doesnothavetheundesirable effects ofmorphine anditissuggested that this drugistobepreferred tomorphine fortherelief ofpain inacutediverticulitis.