The Effect of Analgesic Drugs on Respiratory Center
Status:
Recruiting
Trial end date:
2021-12-30
Target enrollment:
Participant gender:
Summary
Opioids are commonly used in analgesic treatment of severe patients. Opioid receptors are
divided into five types:,,, and.1 receptor is associated with analgesia and sedation above
the spinal cord, while 2 receptor is associated with respiratory depression, bradycardia,
euphoric sensation, pruritus, pupil contraction, inhibition of intestinal motility and other
side effects.Κ receptors play a role of spinal analgesia, sedation and diuresis.Δ receptors
associated with spinal analgesia and respiratory inhibition and regulate the activity of mu
receptor.
Different opioid analgesics have different binding degree with different receptors, which
determines the difference of analgesic effect and side effect, especially respiratory central
inhibitory effect.Remifentanil is a pure opioid receptor agonist, mainly ACTS on the first
and second receptors, binding to the second receptor is weak, in the analgesic, sedative
effect, with opioid respiratory depression and hypotensive side effects, respiratory
depression is dose dependent.Nalbuphine hydrochloride has strong analgesic effect, quick
effect and long time by stimulating receptor, and has partial antagonistic effect on the
receptor, so the incidence of respiratory depression is low in theory.The metabolic pathways
of different opioids are also different. In particular, severe patients often need continuous
opioid infusion for analgesia, which may lead to the accumulation of drugs and further affect
the respiratory center.In the process of continuous application of different types of opioids
to the analgesia of severe patients, the presence of respiratory center inhibition, the
degree of inhibition and the dose-effect relationship have not been quantitatively evaluated.