红细胞包蔽吗啡溶液用于术后镇痛的临床研究  

A clinical study on morphine encapsulated in erythrocytes for postoperative analgesia

作　　者：汪小海[1] 骆璇[1] 朱世俊[1] 徐鑫[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《临床麻醉学杂志》2001年第2期80-81,共2页Journal of Clinical Anesthesiology

基　　金：江苏省社会发展基金!资助项目 (编号 :BS2 0 0 0 0 5 6 )

摘　　要：目的　探讨红细胞包蔽吗啡 (RBC M)溶液用于术后镇痛的可行性。方法　 (1)采用放免法测定RBC M溶液红细胞 (RBC)内外吗啡 (M )的浓度 ;(2 )采用双盲法和视觉模拟评分 (VAS)法比较研究了择期上腹部手术病人应用RBC M和M后 (各 2 0例 )术后镇痛的时效 ,并同时观察了术后病人恶心呕吐及瘙痒等症状的发生率 ;(3)从上述病例中各随机选择 8例 ,均分别于静脉给药后 2、5、10、30分钟 ,以及 1、2、4、8、10、2 4小时测动脉血吗啡浓度。结果　 (1)RBC M溶液RBC内外吗啡的浓度无显著差异性 ;(2 )RBC M组术后 2 4小时疼痛VAS评分显著高于M组 ,两组病人术后恶心呕吐和瘙痒等副作用的发生率无统计学差异 ;(3)药时曲线以二室模型的拟合相关性最好 ,RBC M组的t 1/ 2 (α)和t 1/ 2 (β)与M组相比均显著延长。 结论　RBC M溶液术后镇痛的时效可满足术后镇痛的需要 ,且具有较好的安全性。Objective To study the feasibility to use morphine encapsulated in erythrocytes for postoperative analgesia.Methods The concentrations of morphine inside and outside RBC in RBC M solutions,the effect of RBC M solutions on postoperative analgesia and the pharmacokinetics of RBC M solutions were investigated.Results (1)The concentrations of morphine inside and outside RBC were 3 0±1 28mg/ml and 2 33±1 04mg/ml respectively( P> 0 05);(2)The VAS scores in postoperative 24h was significantly lower in group RBC M than those in group M,and the occurrence of nausea,emetic and itch episode in group RBC M was not significantly different from that group M;(3)The values of t1/2(α) and t1/2(β) were significantly longer in group RBC M than those in group M.conclusion RBC M solutions is more potent for postoperative analgesia than the M solution.

关 键 词：红细胞 药物载体 吗啡 镇痛 手术后 RBC-M 

分 类 号：R619[医药卫生—外科学] R441.1[医药卫生—临床医学]