Adverse effects of opioid analgesic treatment are correlated with a significant elevation in plasma epinephrine in healthy humans
Adverse effects of opioid analgesic treatment are correlated with a significant elevation in plasma epinephrine in healthy humans
复制标题
阿片类镇痛治疗的不良反应与健康人血浆肾上腺素显着升高相关
DOI：
--
复制
发表时间：
2000
影响因子：
2.9
通讯作者：
P. Högger
中科院分区：
文献类型：
--
作者：
P. Högger
摘要目的：本研究的目的是阐明血浆中的儿茶酚胺浓度与经验的疼痛强度和镇痛效果的设置与人类志愿者的实验性疼痛研究的关系。
研究方法：血浆去甲肾上腺素和肾上腺素浓度的12名健康的人类志愿者进行了分析之前和期间疼痛的电牙髓刺激下的药物治疗使用高效阿片类镇痛剂替利定在固定的替利定/纳洛酮组合和非甾体抗炎药溴芬酸。将儿茶酚胺水平与药效学作用和报告的不良反应进行比较。
结果如下：替利定/纳洛酮给药后60-90分钟，儿茶酚胺水平显示血浆肾上腺素浓度（但非去甲肾上腺素浓度）出现统计学显著性增加。在所有报告的病例中，这与涉及眩晕发作的不良反应的发生相关。相比之下，肾上腺素或去甲肾上腺素血浆浓度与疼痛和镇痛的经历没有明显的对应关系。作为比较，在使用非阿片类镇痛剂溴芬酸的药物治疗下，仅注意到一种轻度不良反应，并且在实验期间不能确定血浆肾上腺素或去甲肾上腺素的变化。
结论：有人提出，血浆肾上腺素浓度升高是一个新确定的阿片类药物诱导的眩晕反应，这可能具有临床意义。
AbstractObjective: The purpose of this study was to elucidate the relationship of plasma catecholamine concentrations with experienced pain intensity and analgesic effects in the setting of an experimental pain study with human volunteers.
Methods: Plasma norepinephrine and epinephrine concentrations of 12 healthy human volunteers were analysed before and during painful electrical tooth-pulp stimulation under medication using the highly potent opioid analgesic tilidine in a fixed tilidine/naloxone combination and with the non-steroidal anti-inflammatory agent bromfenac. Catecholamine levels were compared with pharmacodynamic effects and reported adverse effects.
Results: Catecholamine levels revealed a statistically significant increase in plasma epinephrine concentrations (but not norepinephrine concentrations) 60–90 min after administration of tilidine/naloxone. This was correlated with the onset of adverse effects involving vertigo episodes in all reported cases. In contrast, there was no obvious correspondence of epinephrine or norepinephrine plasma concentrations to the experience of pain and analgesia. For comparison, under medication with the non-opioid analgesic bromfenac, only one mild adverse effects were noted, and no changes in plasma epinephrine or norepinephrine could be determined during the experimental sessions.
Conclusions: It is proposed that elevated plasma epinephrine concentrations are a newly determined response to opioid-induced vertigo; this has possible clinical implications.