吗啡对低氧-高碳酸血症的通气反应有潜在的有害影响。

Walter J May, Fraser Henderson, Ryan B Gruber, Joseph F Discala, Alex P Young, James N Bates, Lisa A Palmer, Stephen J Lewis
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引用次数: 15

摘要

本研究探讨了吗啡对低氧-高碳酸血症挑战的通气控制系统有潜在有害作用的概念。在这项研究中,我们研究了在吗啡(10mg /kg)对动脉血气化学和分钟通气的影响消退时,清醒大鼠在低氧高碳酸血症刺激下引起的通气反应。吗啡引起动脉血气化学的显著变化(例如,二氧化碳分压增加,pO2和sO2减少)和分钟通气量减少。尽管吗啡引起的动脉血气化学和微小通气的变化完全解决了,并且几乎完全解决了对吸气和呼气峰值流量的影响,但随后暴露于低氧高碳酸血症挑战导致微小通气、吸气和呼气峰值流量明显减弱。这些研究结果表明:(1)吗啡引起的动脉血气化学变化平行于分钟通气的变化,而不是PIF和PEF的变化;(2)吗啡对低氧-高碳酸血症挑战的通气反应有潜在的不良影响。这些新发现提出了一种可能性,即认为已经从吗啡的急性通气抑制作用中恢复的患者可能仍然容易受到这种阿片类镇痛药的潜在作用的影响。这些潜在影响的机制仍有待阐明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Morphine has latent deleterious effects on the ventilatory responses to a hypoxic-hypercapnic challenge.

This study explored the concept that morphine has latent deleterious actions on the ventilatory control systems that respond to a hypoxic-hypercapnic challenge. In this study, we examined the ventilatory responses elicited by hypoxic-hypercapnic challenge in conscious rats at a time when the effects of morphine (10 mg/kg) on arterial blood-gas chemistry and minute ventilation had subsided. Morphine induced pronounced changes in arterial blood-gas chemistry (e.g., an increase in pCO2, decreases in pO2 and sO2) and decreases in minute ventilation. Despite the complete resolution of the morphine-induced changes in arterial blood-gas chemistry and minute ventilation and almost complete resolution of the effects on peak inspiratory flow and peak expiratory flow, subsequent exposure to hypoxic-hypercapnic challenge elicited markedly blunted increases in minute ventilation and in peak inspiratory and expiratory flows. These findings demonstrate that (1) the changes in arterial blood-gas chemistry elicited by morphine parallel changes in minute ventilation rather than PIF and PEF, and (2) morphine has latent untoward effects on the ventilatory responses to hypoxic-hypercapnic challenge. These novel findings raise the possibility that patients deemed to have recovered from the acute ventilatory depressant effects of morphine may still be susceptible to the latent effects of this opioid analgesic. The mechanisms underlying these latent effects remain to be elucidated.

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