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Department of Anesthesiology- Research Division |
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Dr. Naughton's research program focuses on the fact that intrathecal opioids are frequently administered for postoperative analgesia and analgesia for labor and delivery. This route of administration offers superior pain relief; however, it can be accompanied by a number of side effects. The most common side effect is pruritus. Itching associated with the administration of intrathecal morphine has a reported incidence between 30-100%, and can detract from the quality of analgesia. Current investigations focus on the efficacy of various therapeutic antipruritics and mechanism of intrathecal opioid induced pruritus. The first phase of the investigations focused on the development of a non-human primate model, the rhesus monkey, to study itching. This has been completed and two drugs, nalmefene and ketorolac have been studied as antipruritics. Future drug studies include ondansetron and kappa opioid agonists. Future mechanism investigations will focus on the role of intermediary peptides as secondary messengers as part of the opioid mediated effect. Clinical investigations focus on the efficacy of therapeutic agents in the parturient receiving intrathecal opioids for postoperative analgesia. Currently, nalmefene, a long acting mu receptor antagonist, is being trialed. Effects studied include duration and side effects of nalmefene as well as characterization of intrathecal morphine analgesia. The study design uses the up-down sequential model to determine the ED50 for intravenous nalmefene. Recent Publications: 1. Lee H, Naughton NN, Woods JH, Ko MC. Characterization of scratching responses in rats following centrally administered morphine or bombesin. Behav Pharmacol. 14:501-508, 2003. [PubMed] 2. Lee PJ, MacLennan A, Naughton NN, O'Reilly M. An analysis of reintubtations from a quality assurance database of 152,000 cases. J Clin Anesth. 15:575-81, 2003. [PubMed] 3. Ko MCH, Lee H, Song MS, Sobczyk-Kojiro K, Mosberg HI, Kishioka S, Woods JH, Naughton NN: Activation of kappa-opioid receptors inhibits pruritus evoked by subcutaneous or intrathecal administration of morphine in monkeys. Journal of Pharmacology and Experimental Therapeutics 305:173-179, 2003. [PubMed] 4. Ko MCH, Lee H, Harrison C, Clark MJ, Song HF, Naughton NN, Woods JH, Traynor JR. Studies of mu-, kappa-, and delta-Opioid receptor density and G protein activation in the cortex and thalamus of monkeys. Journal of Pharmacology and Experimental Therapeutics 306: 179-186, 2003. [PubMed] 5. Polley LS, Columb MO, Naughton NN, Wagner DS, van de Ven CJM, Goralski K. Relative analgesic potencies of levobupivacaine and ropivacaine for epidural analgesia in labor. Anesthesiology 99: 1354-1358, 2003. [PubMed] 6. Ko MC, Song MS, Edwards T, Lee H, Naughton NN. The role of central mu opioid receptors in opioid-induced itch in primates. J Pharmacol Exp Ther. 310:169-76, 2004. [PubMed] 7. Mhyre JM, Riesner MN, Polley LS, Naughton NN. A series of anesthesia-related maternal deaths in Michigan, 1985-2003. Anesthesiology, 106 (6): 1096-1104 Jun 2007. [PubMed] Research Divisions | ||||||
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