Long-term intrathecal morphine influence on major compounds of the endocrine system in elderly population |
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| Authors: | William Raffaeli Boaz Gedaliahu Samolsky Dekel Melotti Rita Donatella Righetti Alessandro Caminiti Marco Balestri Donatella Sarti Fanelli Guido |
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| Institution: | 1. Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA;2. Departments of Anesthesiology and Biomedical Informatics, Vanderbilt University, Nashville, TN;3. Harvard Medical School, Boston MA;1. Program in Cell & Molecular Biology, Colorado State University, Department of Biomedical Sciences, Fort Collins, CO, USA;2. Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, USA;3. School of Biomedical Engineering, Colorado State University, Fort Collins, CO, USA;1. School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan;2. Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 40447, Taiwan;3. Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan;1. Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;2. Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;3. The Center for Botanical Lipids and Inflammatory Disease Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;4. Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;5. Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;6. Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;7. Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA |
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| Abstract: | BackgroundThe influence of long-term opioid administration on hormonal levels is not well characterized in the literature. We previously showed that intrathecal opioid therapy significantly influences the homeostasis of immune and endocrine systems. Other authors confirmed that exogenous and endogenous opioids induce this effect. They have a cytokine-like behavior and may function as neurotransmitters, neuromodulators or hormones, as concerning their synthesis, storage and release.AimsTo assess the effects of morphine long-term intrathecal administration on serum levels of Gonadal, Thyroidal and Adrenal axis hormones in an elderly population affected by chronic pain; to assess the correlation between hormone levels and morphine dosage.MethodsPatients suffering from chronic non-cancer pain with or without intrathecal drug delivery system were studied and hormonal levels were monitored, using an immunoradiometric assay kit.ResultsThe long-term administration of intrathecal morphine influenced part of the endocrine system, in particular, there was a reduction of FSH and LH and an increment of GH serum levels; this effect was morphine dose dependent.ConclusionLong-term intrathecal opioid administration influenced FSH, LH and GH serum levels. Data on this issue are inadequately described in the literature. The finding of endocrine effects of opioid therapy, nonetheless, cannot be ignored, as it may have clinical relevance in both elderly and young population. We believe that during long intrathecal pain treatments with morphine, clinicians should be aware of both immediate and later opioids side effects, and in particular, they should monitor immune and endocrine changes. |
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