Tryptophan-morphine interactions and postoperative pain



Title Tryptophan-morphine interactions and postoperative pain
Author(s) K. B. Franklin, F. V. Abbott, M. J. English, M. E. Jeans, R. Andrew R. Tasker, S. N. Young
Journal Pharmacology, Biochemistry, and Behavior
Date 1990
Volume 35
Issue 1
Start page 157
End page 163
Abstract Patients undergoing abdominal surgery were infused with saline or the 5-hydroxytryptamine (5-HT) precursor tryptophan starting in the operating room and continuing for three hours in the recovery room. There was a nonsignificant trend for patients who received tryptophan to have higher pain scores. In the saline-treated patients, plasma tryptophan was below the range for normal healthy subjects, and there was a strong positive relationship between plasma tryptophan and morphine requirements. These data, taken together with animal data obtained using the formalin pain test, suggest that a 5-HT system in the brain can antagonize the dissociative state produced by morphine, which helps patients to tolerate pain. When plasma tryptophan falls below normal levels, brain 5-HT falls and morphine requirements are reduced. While tryptophan may potentiate spinal 5-HT function to decrease nociceptive afference in some circumstances, there may be clinical conditions in which the use of tryptophan is contraindicated.

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