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Histamine release by morphine and diamorphine in man
D E Withington1, J A Patrick, F Reynolds
1United Medical and Dental School, Guys Hospital, London.
Anaesthesia
|January 1, 1993
Summary
Morphine and diamorphine, used for postoperative pain relief, both trigger histamine release. This study suggests these opioids release histamine from mast cells, not basophils, with no significant hemodynamic effects observed.
Area of Science:
- Pharmacology
- Anesthesiology
- Immunology
Background:
- Intravenous morphine and diamorphine are common postoperative analgesics.
- Their comparative histamine-releasing potential in humans remains unquantified.
Purpose of the Study:
- To compare the histamine-releasing effects of intravenous morphine and diamorphine in patients undergoing abdominal surgery.
Main Methods:
- Thirty-eight patients received either morphine (0.16 mg.kg-1) or diamorphine (0.08 mg.kg-1).
- Plasma histamine levels were measured using an isotopic radioenzymatic technique at timed intervals post-administration.
- Hemodynamic parameters, pain scores, and basophil histamine release were also assessed.
Main Results:
- Significant histamine release occurred in 23.5% of the morphine group and 21.1% of the diamorphine group.
- Histamine release was observed earlier with diamorphine administration.
- No significant changes in hemodynamic parameters or histamine release from basophils were detected.
Conclusions:
- Both morphine and diamorphine induce histamine release in a subset of patients.
- Findings indicate that histamine release originates from mast cells rather than basophils.
- Clinical implications for postoperative pain management with these opioids warrant further investigation.