The pupillary effects of intravenous morphine, codeine, and tramadol in volunteers
The pupillary effects of intravenous morphine, codeine, and tramadol in volunteers
复制标题
DOI：
10.1213/01.ane.0000116924.16535.ba
复制
发表时间：
2004-07-01
影响因子：
5.7
通讯作者：
Hobbs, GJ
中科院分区：
文献类型：
--
作者：
Knaggs, RD;Crighton, IM;Hobbs, GJ
阿片类镇痛剂在包括眼睛在内的许多器官系统中具有药理作用。由于吗啡和可待因的代谢产物有助于其总体药理作用，因此在6小时内进行瞳孔直径测量。我们在10名健康志愿者中研究了静脉注射吗啡（0.125 mg/kg）、可待因（1 mg/kg）、曲马多（1.25 mg/kg）或安慰剂（10 mL 0.9% w/v氯化钠）的瞳孔效应。使用瞳孔密度计每30分钟测量瞳孔直径。使用重复测量的方差分析比较每种药物的瞳孔直径变化。安慰剂给药后未观察到瞳孔直径的显著变化。静脉注射吗啡和可待因后，瞳孔直径减小26%（P < 0.001）。在研究期间，瞳孔直径逐渐恢复到基线值。曲马多给药后150 min瞳孔直径无明显变化，给药后150 min瞳孔直径明显缩小（P < 0.01）。瞳孔直径的变化可以部分地由所研究的阿片类药物的药代动力学特征来解释。瞳孔直径的测量可能在监测阿片类药物的中枢效应中占有一席之地。
Opioid analgesics have pharmacological effects in many organ systems, including the eye. Because the metabolites of morphine and codeine contribute to their overall pharmacological effect pupil diameter measurements were made over a 6-h period. We studied the pupillary effects of IV morphine (0.125 mg/kg), codeine (1 mg/kg), tramadol (1.25 mg/kg), or placebo (10 mL 0.9% w/v sodium chloride) in 10 healthy volunteers. Pupil diameter was measured every 30 min using a pupil densitometer. Comparisons of the change in pupil diameter for each drug were made using analysis of variance with repeated measures. No significant change in pupil diameter was observed after placebo. After IV morphine and codeine administration there was a 26% decrease in pupil diameter (P < 0.001). Over the course of the study period, pupil diameter gradually returned to baseline values. After administration of tramadol there were no significant changes in pupil diameter until 150 min after administration, after which there was a significant reduction for the remainder of the study period (P < 0.01). The changes in pupil diameter may be explained in part by the pharmacokinetic profiles of the opioids studied. Measurement of pupil diameter may have a place in monitoring the central effect of opioids.