Action of Morphine on the Intestine in Peritonitis.

Abstract

For many years the administration of morphine in peritonitis has been advocated by many surgical authorities. It has been advocated not only for the relief of pain and distress, but for the purpose of putting the intestine at rest in order to restrict or prevent the spreading of the infection that intestinal motility might produce. The well established observation that morphine tends to produce constipation was interpreted to mean that morphine did stop intestinal motility.

Plant and Miller 1 reported observations that both in the dog and man, morphine produces an increase in intestinal tone and an increased frequency of contractions, contradicting the current conception that morphine decreases intestinal activity.

Because of the relatively established position of the use of morphine in the treatment of peritonitis it was of interest to determine if the existence of a peritonitis modified the type of response to the usual therapeutic doses.

Peritonitis was produced in 10 dogs by the injection of fecal emulsions or by allowing a segment of intestine to drain into the peritoneal cavity. Intestinal motility was recorded from a balloon placed either in a Thiery-Vella fistula or in the intestinal tract. In every instance the subcutaneous injection of 10 mg. of morphine sulphate produced an augmentation of intestinal activity which was not antagonized by atropine sulphate, except in 2 instances in which during the 12 hours preceding death, spontaneous movements were absent and the intestine failed to respond to either morphine or physostigmine.