Comparison of analgesic effects of epidural morphine and epidural non-morphine drugs

硬膜外吗啡与硬膜外非吗啡药物镇痛效果比较

• 批准号: 08660379
• 负责人: NISHIMURA Ryohei
• 金额: $ 1.54万
• 依托单位: The University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08660379/
• 关键词: opioid; morphine; analgesia; epidural; pain manegement; buprenorphine; bupivacaine; butorphanol; 鎮痛薬; 内臓痛; 体性痛; メデトミジン; ミダゾラム

This study was designed to develop the clinically effective epidural non-morphine for post-operative analgesia and the followings are the results and conclusion.1) Epidural morphine was effective for both somatic and visceral pain in rat model. In contrast, epidural administration of medetomidine (a sedative), midazolam (a tranquilizer), ketamine (an anesthetic), and non-morphine opioids(butorphanol and buprenorphine)induced only mild to moderate analgesia. The combinations of these drugs except for morphine were not also very effective for analgesia.2) Epidural administration of high dose of local anesthetics(lidocaine and bupivacaine)induced potent analgesia, however the duration of analgesia was short and caused severe ataxia of pelvic limbs. The combinations of low dose of bupibavacaine and butorphanol or buprenorphine induced potent analgesia against either somatic or visceral pain without apparent ataxia. These combinations, especially the combination of bupivacaine and buprenorphine may be a substitute of morphine when used epidurally.3) Epidural morphine or bupivacaine and buprenorphine were effective for post-operative pain management in clinical cases that were underwent various surgery. Although the higher dose of bupivacaine than the dose which was estimated from the results obtained above was needed, epidural bupivacaine and buprenorphine caused mild ataxia in dog cases. In conclusion, epidural bupivacaine and buprenorphine is effective for post-operative analgesia in dogs.

本研究旨在开发一种临床有效的硬膜外非吗啡术后镇痛方法，其结果和结论如下：1）硬膜外吗啡对大鼠躯体痛和内脏痛均有较好的镇痛效果。相比之下，硬膜外给予美托咪定（镇静剂）、咪达唑仑（镇静剂）、氯胺酮（麻醉剂）和非吗啡阿片类药物（布托啡诺和丁丙诺啡）仅诱导轻度至中度镇痛。2）硬膜外注射大剂量局麻药（利多卡因和布比卡因）镇痛效果明显，但镇痛持续时间短，且引起严重的骨盆运动失调。低剂量布比卡因和布托啡诺或丁丙诺啡的组合诱导对躯体或内脏疼痛的有效镇痛，而没有明显的共济失调。3）硬膜外吗啡或布比卡因+丁丙诺啡用于各种手术后疼痛的镇痛效果较好。尽管需要比从上述结果估计的剂量更高的布比卡因剂量，但硬膜外布比卡因和丁丙诺啡在犬病例中引起轻度共济失调。总之，硬膜外布比卡因和丁丙诺啡用于犬术后镇痛是有效的。

项目成果

Morimoto, K., Ohta, M., Nishimura, R., Matsunaga, S., Mochizuki, M., and Sasaki, N.: "Epidural administration of morphine for pest operative analgesia in dogs" Japan J.Vet.Aresth.Surg.29. 83-90 (1998)

Morimoto, K.、Ohta, M.、Nishimura, R.、Matsunaga, S.、Mochizuki, M. 和 Sasaki, N.：“硬膜外给药吗啡用于狗的害虫手术镇痛”Japan J.Vet.Aresth。

森本啓子,太田稔,西村亮平,松永悟,望月学,佐々木伸雄: "モルヒネの硬膜外投与による犬の術後鎮痛効果" 獣医麻酔外科学雑誌. 29. 83-90 (1998)

Keiko Morimoto、Minoru Ota、Ryohei Nishimura、Satoru Matsunaga、Manabu Mochizuki、Nobuo Sasaki：“狗硬膜外注射吗啡的术后镇痛效果”《兽医麻醉学与外科杂志》29. 83-90 (1998)。

森本啓子 太田稔 西村亮平 松永悟 望月 学,佐々木伸雄: "モルヒネの硬膜外投与による犬の術後鎮痛効果" 獣医麻酔外科雑誌. 29. 83-90 (1998)

Keiko Morimoto、Minoru Ota、Ryohei Nishimura、Satoru Matsunaga、Manabu Mochizuki、Nobuo Sasaki：“狗硬膜外注射吗啡的术后镇痛效果”《兽医麻醉学与外科杂志》29. 83-90 (1998)。