جستجوی مقالات مرتبط با کلیدواژه « Morphine » در نشریات گروه « پزشکی »

Opioid analgesics like morphine and methadone are widely used for managing severe pain; however, concerns over their potential misuse and adverse effects on the brain and reproductive system are significant.

We aimed to investigate their impacts on spermatogenesis and cognitive function in male Norway rats.

In this experimental study, 36 male Norway rats (250-300 gr, 6 months old) were divided into 6 groups: low-dose morphine, high-dose morphine, low-dose methadone, high-dose methadone, positive control (received normal saline at 5 mg/kg), and negative control (received no treatment). Morphine and methadone were administered intraperitoneally over 30 days at doses of 3 mg/kg and 7 mg/kg, respectively. Behavioral assessments evaluated anxiety, stress, and short- and long-term memory. Sperm parameters (viability, motility, morphology), hormonal analysis (testosterone, luteinizing hormone, follicle-stimulating hormone, estradiol), and gene expressions (Tp53, CatSper1) were assessed.

A significant reduction in rat weight was observed in the high-dose morphine group (p = 0.0045), while testicular weights remained unchanged. Sperm abnormalities were observed with high doses of methadone and morphine. High-dose methadone significantly reduced offspring count (p = 0.0004). Levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol varied significantly across treatment groups. Gene expression was altered in response to treatments (p < 0.05).

Prolonged exposure to methadone and morphine resulted in memory dysfunction, chronic stress, hormonal disturbances, altered gene expression, and fertility complications. These effects were more pronounced at higher doses, highlighting the importance of careful dosage management in opioid therapy.

Perioperative pain management can improve surgery results and patient outcomes. Moreover, multimodal methods for pain control have been advised so this study was conducted to assess the beneficial impact of preoperative ultrasound-guided femoral nerve blocks in hip replacement surgery.

This study is a double-blinded clinical trial including 60 individuals who were candidates for joint replacement surgery. The intervention group (n = 30) received a femoral nerve block prior to general anesthesia.

 After surgery, patients received morphine, Apotel, and morphine + Apotel, all of which were administered at lower doses in the intervention group (femoral nerve block) than in the control group. Pain intensity in first hour (P= 0.01), 4 hours (P= 0.003), 8 hours (P= 0.01), 12 hours (P= 0.001), and 24 hours (P= 0.01) after surgery and average pain 4 hours (P= 0.01), 8 hours (P = 0.01), 12 hours (P = 0.02), and 24 hours (P= 0.01) after surgery was significantly less in the intervention group (femoral nerve block) than in the control group.

The findings of our investigation demonstrated the efficacy of ultrasound-guided femoral nerve blocks in the improvement of pain control following hip replacement surgery.

The adrenergic and opioidergic systems play a crucial role in regulating cognitive and non-cognitive behaviors. The aim of this study was to evaluate the effects of CA1 α2-adrenoceptors on the exploratory behaviors induced by morphine.

This assessment was conducted in rats using the elevated plus-maze test based on a test-retest paradigm. Bilateral guide cannulas were stereotaxically implanted in the CA1 regions of rats to allow intra-CA1 α2-adrenoceptors agonist (clonidine) or antagonist (yohimbine) microinjections.

Pre-test administration of morphine (6 mg/kg) showed an anxiolytic-like response. The extension of this effect during the retest session, 24h later, indicated impairment of aversive memory. Pre-test microinjection of clonidine (4 µg/rat) induced anxiolytic-like behavior on the test day in the absence or presence of a subthreshold dose of morphine (4 mg/kg) and increased avoidance to the open-arms during the retest session, but it was not significant compared with control group. Pre-test microinjection of yohimbine (4 µg/rat) induced an anxiogenic-like behavior on test day in the absence or presence of an effective dose of morphine (6mg/kg) and increased avoidance to the open-arms during the retest session. Concurrent microinjection of a subthreshold dose of yohimbine (1 μg/rat) with an effective dose of clonidine or with an effective dose of clonidine plus a subthreshold dose of morphine blocked anxiolytic-like behaviors, but did not change avoidance to the open-arms.

According to our findings, it appears that CA1 α2-adrenoceptors affect anxiolytic-like effects of morphine, but they do not appear to play a significant role in the morphine-induced memory impairment.

The aim of this study was to elucidate the efficacy of atorvastatin calcium tablets to relieve morphine tolerance in cancer pain patients.

Cancer patients were randomized into the control and observational groups. The morphine dose increment time (T2), the onset time of morphine (T1), the titration dose and pain management rate in the two groups were evaluated and compared. Adverse events such as nausea, vomiting, constipation and respiratory depression were recorded. The impact of different treatments on the life quality of patients was assessed with Karnofsky performance status (KPS) score. Liver function and hematologic toxicities of different treatment was evaluated and examined.

The duration of T2 was significantly prolonged in the observational group (P=0.04), while the time of T1 as well as the titration dose showed no significant difference between the two groups (P>0.05). The adverse effects were slighter in the observational group (P>0.05). There was no respiratory depression case in either group. The life quality in two groups of patients showed no difference (P>0.05). Liver function and hematologic toxicitie results indicated that the combined treatment showed no extra damage to liver function and had no severe haematologic toxicity compared with the control.

The combined treatment of atorvastatin calcium tablets and morphine effectively prolonged the time between morphine dose increments, alleviating the morphine tolerance with high safety in cancer pain patients, which may provide clues for morphine tolerance treatment in cancer pain management.

Research shows that -Pinene interacts with the opioidergic system.

This study aims to examine the toxicity and the effects of -Pinene on morphine tolerance and dependence in mice.

Guidelines No. 423 and No. 407 were used to investigate acute and sub-chronic toxicity, respectively. For sub-chronic toxicity analysis, the animals were sacrificed on day 28, and blood and tissue samples were collected. After inducing morphine tolerance or dependence, in both phases, animals received i.p. vehicle, diazepam(5 mg/kg), and-Pinene (3.125, 6.25, and12.5 mg/kg). Withdrawal signs were recorded for 30 minutes.

Only the acute dose of -Pinene showed mortality in animals, but mild lesions were seen in the brain, liver, and kidneys in the mice receiving its subchronic dose. Moreover, ALT, AST, ALP, and TG levels increased (P < 0.05) in female mice. Besides, 6.25 and 12.5 mg/kg (P < 0.001) of -Pinene and only its high dose (12.5 mg/kg) (P < 0.001) reduced the number of jumps in the tolerance and dependence phases, respectively. Diarrhea (P < 0.001), writhing (P < 0.001), rearing, and climbing (P < 0.05 and P < 0.001, respectively) behaviors decreased in the tolerance phase, and grooming, climbing, and teeth chattering declined in the dependence phase (P < 0.001).

The LD50 of -Pinene was lower than 2000 mg/kg, but its subchronic dose caused mild tissue toxicities and biochemical changes. Moreover,-Pinene decreased morphine tolerance and dependence and possibly was useful for the treatment of opioid dependence after complimentary trials.

Traditional medicine reported the appropriate analgesic and anti-inflammatory effects of Malva sylvestris, The anti-inflammatory effect, which was proved by literature, made it likely that the plant would be effective in pain modulation. Therefore, the effect of its hydro-alcoholic extract on the analgesic effect of morphine was assessed for reducing morphine dosage.

Pain intensity was assessed using Tail Flick test at spot heat of 55°C and cut off time of 10 seconds on adult male rats. An appropriate dose of morphine to cause analgesia was determined intraperitoneally using dose-response method. The analgesic effect of different doses 100,200,400 and 600 mg/kg of Malva sylvestris extract and the effect of the doses on the analgesic property of an appropriate dose of morphine (2.5mg/kg) were examined.

The best analgesic effect with the ability to increase the threshold for occurrence of tail painful reflex was related to dose 400 mg/kg of the extract, which its highest analgesic effect was observed in minute 45. Administration of the most effective dose of the extract with morphine significantly (pvalue<0.05) increased morphine’s analgesic effect. Naloxone administration, 15 minutes before administration of this dose, could significantly (pvalue<0.05) decrease its analgesic effect.

Hydroalcoholic extract of Malva sylvestris (HEMS) is capable of increasing morphine’s analgesic effect. Some of this effect is through its effect on opioid receptors, which are inhibited by Naloxone as an antagonist of morphine that is probably one of its analgesic mechanisms.

Colorectal cancer is a major cause of morbidity and mortality in Australia. Following colorectal cancer surgery, although systemic opioids are often first-line analgesia, they may be associated with various adverse effects. Intrathecal morphine (ITM) has been shown to provide good analgesia with a safe side effect profile. This study assessed whether ITM alongside patient-controlled analgesia (PCA) reduces the incidence of immediate postoperative adverse effects and post-discharge outcomes compared to PCA alone following colorectal cancer surgery.

In this retrospective cohort study, data from 260 patients undergoing colorectal cancer surgery during 2014-2018 at Peter MacCallum Cancer Centre was extracted from a clinical database and medical records. Immediate postoperative outcomes included pruritus, postoperative ileus, and time to mobilisation. Post-discharge outcomes encompassed chronic postoperative pain and long-term opioid consumption. Cancer recurrence was an exploratory endpoint. Comparative analysis was undertaken for ITM with PCA (the ITM group) compared to PCA alone (the PCA group), overall and after stratification into laparoscopy versus laparotomy procedures.

In total, 260 patients were included in this study (160 in the ITM group and 100 in the PCA group). The ITM group trended toward a lower incidence of postoperative ileus, lower incidence of chronic pain, and opioid use at three and six months but not at twelve months.

Based on the findings, the ITM group trended toward reductions in postoperative ileus, chronic pain, and opioid use at three and six months.

Anxiety is one of the comorbid disorders of opioid addiction, which leads to opioid abuse or persuades people to engage in opioid abuse. Evidence revealed that morphine exposure before conception changes the offspring’s phenotype. The current study aimed to investigate the influence of morphine dependence and abstinence on anxiety-like behavior in morphineexposed and drug-naïve offspring. Adult male and female rats were treated with morphine or vehicle for 21 days. Then, all rats were left without drug treatment for 10 days. A morphine-exposed female rat was mated with either a vehicle-exposed or morphine-abstinent male. According to parental morphine exposure, the offspring were categorized into four distinct groups: (1) control (both drug-naïve parents), (2) paternal morphine-exposed, (3) maternal morphine-exposed, and (4) biparental morphine-exposed. The anxiety-like behavior was measured in adult male offspring using open field and elevated plus-maze tests before morphine exposure (naïve), 21 days after morphine exposure (dependence), and ten days after the last morphine exposure (abstinence).  The results indicated that anxiety-like behavior increased before morphine exposure in maternal and biparental morphineexposed offspring (P<0.05). However, after morphine exposure, the anxiety level did not change among the groups. Ten days after the last morphine exposure, anxiety-like behavior increased only in biparental morphine-exposed offspring (P<0.05).  The offspring of morphine-abstinent parents exhibited an anxious phenotype. Disruption of the HPA axis was seen in the progeny of maternal and biparental morphine-exposed rats. Indeed, morphine exposure for 21 days did not change anxiety-like behavior in these offspring which might be correlated to disruption of HPA axis in them.

Morphine is a narcotic pain reliever that is prescribed to reduce postoperative pain and can produce reactive oxygen species (ROS). Therefore, it can have negative effects on spermatogenesis and male fertility. Vitamin E is an effective antioxidant which plays an important role in membrane lipid peroxidation due to increased ROS. The present study aimed to evaluate the effects of vitamin E and morphine on sperm parameters, level of malondialdehyde (MDA), and diameter of seminiferous tubules in morphine-treated mice.  In this experimental study, 80 mice were divided into ten groups (n=8) including control, normal saline, vehicle, morphine, various doses of vitamin E (100, 200, 300 mg/kg), and morphine plus vitamin E (100, 200, 300 mg/kg) groups. The groups were followed up for 30 consecutive days. Sperm parameters, testis weight, the diameter of seminiferous tubules, and the level of MDA were analyzed and compared. Data analysis showed seminal parameters decreased significantly (excluding sperm count) and there was an increase in the level of MDA in morphine-treated mice compared with the normal saline group (P<0.05). Administration of E100 to morphinetreated mice did not show a significant difference in the evaluated parameters compared with the morphine group. However, E200 and E300 significantly reduced MDA and improved sperm parameters (P≤0.05). The results showed co-administration of vitamin E in high doses (200 & 300) could prevent the deleterious effects of morphine on some reproductive parameters and decrease the level of MDA in morphine-treated mice.

 The pain experienced following supratentorial brain surgery is usually defined as moderate to severe. Therefore, pain-management approaches, including narcotics, are an integral part of treatment regimens that cause respiratory complications or seizures, and reducing this pain level and increasing patient satisfaction is vital.

 This randomized, double-blind clinical trial study to evaluate the pain level and satisfaction in patients undergoing surgery for supratentorial brain neoplasms was performed on two groups with a sample size of 50 patients. In group I, after removal of the brain lesion (at the beginning of dura closure), 400 mg of ibuprofen solution was infused intravenously over 30 minutes. In group II, morphine 0.07 mg/kg intravenously with 1000 mg paracetamol was infused over 30 minutes. After injecting ibuprofen and paracetamol morphine, the patient's pain level and satisfaction with the process were checked.

 Patients' satisfaction score in the first 6 hours in the ibuprofen group was 1.67 ± 0.72, and in the other group was 2.27 ± 0.7, which was statistically different (P-value = 0.029). The mean of VAS in the first, second, third, and fourth hours was not statistically different. In the comparative analysis of the laboratory indicators of platelet function analysis in the two groups, none of the measured items had a significant difference between the two groups in the three measurement periods (P > 0.05).

 Administration of ibuprofen led to pain relief and patient satisfaction comparable to morphine and paracetamol, and after the surgery for supratentorial brain tumors, ibuprofen did not affect the patients’ blood clotting functions.

Given the lack of general standards for pain treatment after orthopedic operations, orthopedists and anesthesiologists need evidence to choose analgesic options for children. Therefore, this paper seeks to evaluate the effectiveness of morphine administration in reducing pain after orthopedic surgery in children in different contexts.

To find study trials on the effect of morphine on pain relief in children with orthopedic surgery, we systematically reviewed PubMed, ISI Web of Science, Embase, Google Scholar, Cochrane, and Scopus databases until March 2020. The following keywords were searched: “Morphine,” “ opioid,” “children,” “pediatric,” “preschool,” “child,” “orthopedic,” “orthopedics,” and “orthopedic procedures” to find relevant papers. The quality of articles was evaluated using the Jadad scale.

Nine studies were included in the meta-analysis. Analgesia with sublingual buprenorphine had an effect similar to the intramuscular morphine. The effect lasted significantly longer in the buprenorphine group than in the morphine group (P=0.03). About 67% of the children experienced pain relief after the first injection and 94% after the second injection (after 15 minutes) of morphine. In the propacetamol group, 77% of the children had pain relief. It is recommended to administer propacetamol initially. If the propacetamol is not effective, a subsequent injection of morphine is suggested after the first injection of propacetamol. About 84.6% of parents in the ketamine group and 66.6% of parents in the morphine group were very satisfied with the analgesic intervention. However, no significant difference was observed between the two groups (P=0.296). According to two studies, the pain score was significantly lower in the morphine group than in the meperidine group (P<0.005). The morphine administered in combination with ketorolac induced greater analgesia compared to the group receiving morphine alone (P=0.002). According to three studies, morphine was not superior to ibuprofen in relieving children’s postoperative pain (P>0.005).

Morphine was more effective than meperidine. However, morphine did not surpass ibuprofen, buprenorphine, and ketamine in treating children with orthopedic pain.

Opiates dependence has many side effects on body especially brain neuroplasticity leading to changes in behavior. In this study, we evaluated the effects of morphine dependence on learning and memory as well as on Peroxisome proliferator-activated receptor gamma coactivator -1 alpha (PGC-1α) protein level as a key regulator of mitochondrial biogenesis. Also, by using Chloroquine (lysosomal inhibitor) and dopaminergic system inhibitor (Sulpiride), the molecular mechanism, underling morphine addiction related to lysosome, dopamine receptors and mitochondria, has been considered in this study.

Male albino Wiastar rats received morphine in their water for 21 days; during the ending 4 days, they received daily intracerebroventricular (i.c.v.) injection of Chloroquine diphosphate (50 mM). Also, i.c.v. injection of Sulpiride (0.25μg/rat) was done before behavioral test. Shuttle box apparatus was used for learning and memory evaluation. After behavioral test, the brains of rats were extracted and the level of PGC-1α protein was investigated by western blotting.

Results indicated that morphine oral administration has reduced learning and memory-like behavior. Pre-training i.c.v. injection of Chloroquine and Sulpiride improved learning and memory. PGC-1α protein level in rats which received Chloroquine and also in the morphine group increased and there was a more significant increase in rats which received morphine, Chloroquine and Sulpiride altogether.

Morphine has an adverse effect on learning and memory as it has been shown with spending more time in dark rooms of Shuttle box apparatus, which was reversed by Chloroquine (lysosomal inhibitor) and dopamine inhibitor (Sulpiride). Increasing PGC-1α protein level may imply the important role of mitochondrial biogenesis in morphine-dependent learning changes. Overall, data suggest dopaminergic system along with lysosome and mitochondrial activity play an important role in morphine addiction status.