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Morphine effects on human colonic myoelectric activity in the postoperative period
C T Frantzides1, V Cowles, B Salaymeh
1Department of Surgery, Medical College of Wisconsin, Milwaukee 53226.
Abstract:
Colonic myoelectrical activity was studied in 25 patients, 18 of whom received morphine sulfate, using bipolar electrodes placed in the ascending and descending colon during laparotomy. Baseline myoelectrical activity was recorded daily, then morphine (3 to 15 mg) was administered intravenously, intramuscularly, or epidurally, and recordings continued. Seven activity patterns were observed during recovery from postoperative ileus. During the first 2 postoperative days, morphine at any dose did not affect colon myoelectrical activity. From the third postoperative day on, morphine given intravenously or intramuscularly initiated clusters of short, nonmigrating, phasic spike bursts occurring on each successive slow wave in 14 of 18 patients, which lasted for 30 to 45 minutes. When morphine was administered epidurally, there was no colonic response in any patient. These findings suggest that: (1) morphine intravenously or intramuscularly induces predominantly nonmigrating colonic spike bursts; (2) morphine-induced activity alters the normal pattern of colonic motility during recovery from postoperative ileus; and (3) these phenomena are not due to direct action of morphine on the spinal cord since epidural morphine had no effect.
Insights
Morphine administration affects colonic myoelectrical activity during postoperative ileus recovery. Intravenous or intramuscular morphine induces specific spike bursts, altering normal colonic motility patterns.
Area of Science:
- Gastroenterology
- Pharmacology
- Surgical Recovery
Background:
- Postoperative ileus is a common complication following abdominal surgery.
- Colonic myoelectrical activity plays a crucial role in gastrointestinal motility.
- Understanding the impact of analgesics on gut function is vital for patient recovery.
Purpose of the Study:
- To investigate the effects of morphine sulfate on colonic myoelectrical activity in patients recovering from surgery.
- To determine if the route of morphine administration influences its impact on colonic motility.
Main Methods:
- Bipolar electrodes were used to record colonic myoelectrical activity in 25 patients during laparotomy.
- Morphine sulfate (3-15 mg) was administered intravenously, intramuscularly, or epidurally on postoperative days.
- Activity patterns were analyzed during recovery from postoperative ileus.
Main Results:
- Morphine did not affect colonic activity in the first two postoperative days.
- From postoperative day three, intravenous or intramuscular morphine induced nonmigrating spike bursts in 14/18 patients.
- Epidural morphine administration showed no effect on colonic myoelectrical activity.
Conclusions:
- Intravenous and intramuscular morphine induce specific colonic spike bursts, altering motility during ileus recovery.
- The observed effects are not due to direct spinal cord action, as epidural morphine was ineffective.
- Morphine's impact on colonic motility is route-dependent and emerges later in the postoperative period.