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Department of Surgery, Kurume University, School of Medicine, Kurume 830, Japan
Fentanyl citrate analgesia attenuates the excess
nitrogen excretion in the urine and glucose production induced by
trauma. On the other hand, intracerebroventricular injection of
morphine stimulates excretion of stress hormones, such as
catecholamines and corticosterone. Furthermore, morphine levels in the
brain are increased during fasting and sepsis. The aims of this study were to determine whether intracerebroventricular injection of tumor
necrosis factor-
(TNF-
) elevates morphine levels in the rat brain
and whether prophylactic administration of fentanyl blocks metabolic
responses induced by intracerebroventricular injection of TNF-
because of a reduction of morphine levels in the brain. Morphine levels
in the brain were increased from 648 to 1,134 fmol/g at 30 min after
intracerebroventricular injection of TNF-
(P < 0.05 vs. control). This
increase was associated with an increase in stress hormones
(corticosterone: 416.1 ± 69.1 ng/ml,
P < 0.05 vs. control; epinephrine:
3,778.3 ± 681.3 pg/ml, P < 0.01 vs. control) and an enhancement of proteolysis (254.2 ± 45.7 µmol
Leu · kg
1 · h
1,
P < 0.01 vs. control) and glucose
production (7.5 ± 0.7 mg · kg
1 · min
1,
P < 0.05 vs. control). Fentanyl
reduced morphine levels in the brain to 624 fmol/g (not significant vs.
control), resulting in a reduction of stress hormone levels in the
plasma and blunted metabolic responses. In conclusion, prophylactic
administration of fentanyl prevented an increase in morphine levels in
the brain induced by intracerebroventricular injection of TNF-
,
leading to a reduction in stress hormone levels and subsequent
metabolic responses.
protein turnover; glucose turnover; cytokine
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