Eur J Pain. 2005 Apr;9(2):105-8. Opioid analgesia in the newborn. Nandi R1, Fitzgerald M. Abstract Pain in neonates is now well established. Studies of the developmental neurobiology of pain have revealed that pain processing in the immature is very different from that in the mature nervous system. Neonates undergo considerable maturation of peripheral, spinal and supraspinal afferent pain transmission over the early postnatal period but are able to respond to tissue injury with specific behaviour and with autonomic, hormonal and metabolic signs of stress and distress. Opioid analgesia is now widely used in neonates. There is evidence that morphine requirements may be low in the youngest patients. Sensory threshold testing in rat pups has shown that the analgesic potency of systemic morphine mechanical stimulation is significantly greater in the neonate and declines with postnatal age. The changing morphine sensitivity in the postnatal period may be part of a general reorganization in the structure and function of primary afferent synapses, neurotransmitter/receptor expression and function and excitatory and inhibitory modulation from higher brain centres. Importantly opioid receptor expression undergoes significant developmental regulation - mu opioid receptors, observed to be exuberantly expressed in the neonatal rat, have been found to be functional. These findings have important implications for the human neonate as they provide a possible explanation for the differences in morphine requirements observed in the youngest patients. The study of the underlying mechanisms of pain and analgesia in development has enabled important changes in clinical practice. However, pain in the newborn remains poorly understood and continued research and intensive study in this area is essential for further effectiveanalgesic intervention and the discovery of new targets for therapy. 我解讀的部分如下 1.Pain in neonates is now well established. Studies of the developmental neurobiology of pain have revealed that pain processing in the immature is very different from that in the mature nervous system. 主要在講神經構造的發展成熟度，會導致疼痛的發生過程（機轉）非常不一樣 2.Neonates undergo considerable maturation of peripheral, spinal and supraspinal afferent(傳入的) pain transmission over the early postnatal period but are able to respond to tissue injury with specific behaviour and with autonomic, hormonal and metabolic signs of stress and distress. 疼痛在小兒身上，會因造成某種身體上的壓力，會導致賀爾蒙及代謝的現象發生 3. There is evidence that morphine requirements may be low in the youngest patients. Sensory threshold testing in rat pups has shown that the analgesic potency of systemic morphine mechanical stimulation is significantly greater in the neonate and declines with postnatal age 證據顯示，嗎啡的需求劑量，在年紀越小的小朋友需求越低。在老鼠的疼痛閾值試驗中， 顯示出，因嗎啡刺激所造成止痛的強度，在neonate上是有顯著的好， 並且declines with postnatal age。(什麼是declines with postnatal age?) 4. Importantly opioid receptor expression undergoes significant developmental regulation - mu opioid receptors, observed to be exuberantly expressed in the neonatal rat, have been found to be functional. These findings have important implications for the human neonate as they provide a possible explanation for the differences in morphine requirements observed in the youngest patients. 這段在說，嗎啡的受體，在剛出生的小鼠有顯著的成熟，並且是有功能的。 這個發現說明了，為什麼在年紀小的病人，嗎啡的需求量會差異這麼大。 以上就是我所瞭解的部分，不過是非常殘缺不全的理解 請版上大大幫忙了 感謝 --

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