Unwanted effects of morphine-6-glucuronide and morphine
Unwanted effects of morphine-6-glucuronide and morphine
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DOI：
10.1046/j.1365-2044.2002.02624_2.x
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发表时间：
2002-12-01
期刊：
影响因子：
10.7
通讯作者：
Ho, B
中科院分区：
文献类型：
--
作者：
Cann, C;Curran, J;Ho, B
吗啡的活性代谢物吗啡-6-葡糖苷酸（M6 G）可能比吗啡具有更少的不良反应。我们随机分配144名妇女接受M6 G或吗啡作为妇科腹腔镜手术的一部分。观察两组患者术后恶心、呕吐、疼痛、镇静、皮疹的发生率及恶心、疼痛、镇静的严重程度。与M6 G组相比，接受吗啡治疗的患者更可能在术后前2小时报告恶心（比值比2.9，CI 1.31-6.21），并且严重程度更高。在同一时间段内，他们更容易呕吐和感到困倦，但两组的疼痛强度和急救镇痛药的使用情况相似。在回家途中和回家后，吗啡组恶心、呕吐和嗜睡的发生率继续较高。第二天早上，吗啡组的患者仍然更困倦，但两组恶心的发生率相似。M6 G的毒性似乎比吗啡更好。需要更多的疗效研究来准确定义全身给药M6 G的镇痛效力。
The active metabolite of morphine, morphine-6-glucuronide (M6G), may have fewer unwanted effects than morphine. We randomly allocated 144 women to receive either M6G or morphine as part of general anaesthesia for day case gynaecological laparoscopy. The incidence of nausea, vomiting, pain, sedation and skin rash, and severity of nausea, pain and sedation after surgery were recorded by direct observation in hospital, and by questionnaire until the next morning. Compared with the M6G group, patients who received morphine were more likely to report nausea in the first 2 h after surgery ( odds ratio 2.9, CI 1.31-6.21) and to suffer it with greater severity. During the same time period, they were more likely to vomit and feel sleepy, but the intensity of pain and use of rescue analgesics were similar in both groups. The incidences of nausea, vomiting and the feeling of sleepiness continued to be greater in the morphine group during and after the journey home. The next morning, patients in the morphine group remained sleepier, but the incidence of nausea was similar for the two groups. M6G appears to have a better toxicity profile than morphine. More efficacy studies are needed to define accurately the analgesic potency of systemically administered M6G.