吗啡伍用小剂量纳洛酮用于镇痛的研究进展

Progress in the Study of Combining Morphine and Low-dose Naloxone for Analgesia

吗啡是临床常用的强效阿片类镇痛药,临床应用中可出现恶心、呕吐、镇静、瘙痒、便秘、尿潴留、呼吸抑制等不良反应,长期应用易出现耐受和依赖。大剂量纳洛酮能拮抗吗啡所产生的全部效应,而小剂量使用不仅能减少或减轻吗啡所致的不良反应,还能增强吗啡的镇痛效能。本文就小剂量纳洛酮与吗啡的联合应用增强吗啡镇痛效能、减弱吗啡耐受和依赖的作用机制,以及拮抗不良反应等方面的研究进展进行综述。

Although morphine is the most effective opioid analgesics, the most widely clinical use has been limited by morphine-induced adverse effects, such as nausea and vomiting, pruritus, constipation, urinary retention,drowsiness and respiratory depression. Tolerance/dependence liaility also appears during chronic opioid administration. Large-dose naluxone can reverse all effects of morphine. Low-dose naloxone not only decrease adverse effects induced by morphine, but also enhance the analgesic efficacy of morphine. This article is a review of the progress in the study of potentiation of analgesic effect, attenuation of tolerance/dependence and reversal of adverse effect of morphine induced by low-dose or ultra-low-dose naloxone.