红细胞包蔽吗啡溶液用于术后镇痛的临床研究

摘要

Objective To study the feasibility to use morphine encapsulatedin 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．%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20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、24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24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t1／2（α）和t1／2（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。