预给小剂量阿片受体拮抗剂对阿片类药物不良反应的影响及研究进展  

Research advances in mechanisms about the effect of pretreatment with low?dose opioid antagonist on opioid?induced side effects

作　　者：王祯 陶玉竹 王仲菲 张麟临 王国林[1] Wang Zhen;Tao Yuzhu;Wang Zhongfei;Zhang Linlin;Wang Guolin(Department of Anesthesiology,Tianjin Medical University General Hospital,Tianjin Institute of Anesthesiology,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院麻醉科,天津市麻醉学研究所,300052

出　　处：《国际麻醉学与复苏杂志》2020年第2期200-203,共4页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金(81801107,81571077,81600962)。

摘　　要：阿片类药物在临床麻醉中应用广泛,通过与阿片受体的特异性结合从而发挥极好的镇痛作用,但其带来的呼吸抑制、痛觉过敏、阿片耐受等副作用也备受关注。纳洛酮、纳美芬等阿片受体拮抗剂常用于麻醉后催醒及解除呼吸抑制,但近年来相关研究发现它们具有更高的临床应用价值。术前予小剂量阿片受体拮抗剂能够明显改善术后阿片耐受及痛觉过敏,并能够减少阿片类药物的用量。文章通过整理归纳相关文献,就预先给予小剂量阿片受体拮抗剂对阿片类药物所致不良反应的预防作用及其机制进行探讨及归纳、总结,旨在为解决阿片类药物临床副作用提供新的思路。Opioid drugs,acting with the opioid receptors,are commonly used in clinical anesthesia and analgesia,but there is no effective preventive strategies for its side effects such as respiratory depression,hyperalgesia,and opioid tolerance.Naloxone and Nalmefene,these two drugs are mainly used for postoperative snooze and respiratory depression relieve.In recent years,it has been re ported that preadministration of ultralow dose opioid receptor antagonists can significantly alleviate postoperative opioid tolerance and hyperalgesia.This review summarized research advances of the effect and potential mechanism of ultralow dose opioid receptor antago nist on adverse reactions induced by opioid receptor agonists.With further study of opioid agonists combined with ultralow dose antago nists,new ideas will be generated for prevention of side effects caused by opioid drugs.

关 键 词：纳洛酮 纳美芬 痛觉过敏 阿片耐受 

分 类 号：R614[医药卫生—麻醉学] R9[医药卫生—外科学]