노인환자의 만성통증에서 morphine의 진통 효능

초록

The mechanisms underlying neuropathic pain alters over time after nerve injury. Thus, a drug that is efficacious in some times may be less efficacious in other times. In the present article, we reviewed that the inconsistent efficacy of morphine in neuropathic pain is related to the different time course after nerve injury. While systemic morphine treatment relieved effectively mechanical allodynia in the early stage of neuropathic pain, its efficacy significantly declined in the late-stage. It seems that morphine efficacy in attenuating neuropathic pain progressively declines over time after nerve injury. Alteration in morphine efficacy may be related to the spinal glial responses to peripheral nerve injury. In the late-stage of neuropathic pain, co-administration of morphine with the blockers of glial activation recovered morphine efficacy to the level of the early stage. Taken together, morphine tolerance in neuropathy progressively occurs over time after nerve injury and it can be prevented by appropriate modulation of spinal glial responses.

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