Physiology of Spinal Opioids and its relevance for Pain Management Selection

Journal Title: Open Journal of Pain Medicine - Year 2017, Vol 1, Issue 1

Abstract

To use spinal opioids appropriately, it is necessary to understand the pharmacokinetics and clinical pharmacology of these drugs including which opioids produce selective spinal analgesia and which do not. Briefl y, spinal selectivity is highest for hydrophilic opioids and lowest for lipophilic opioids. These differences result from natural variations in the bioavailability of opioids at opioid receptors in the spinal cord. The bioavailability differs because lipophilic drugs are more rapidly cleared into the plasma from epidural and intrathecal spaces, than hydrophilic drugs; consequently, they produce earlier supraspinal side effects and have a considerably shorter duration of analgesic action concerning morphine which can produce delay supraspinal adverse effects.

Authors and Affiliations

Bujedo Borja Mugabure

Keywords

Related Articles

Parasternal Block with Two Different Concentration of Ropivacaine for Post-Operative Analgesia in Patient Undergoing Coronary Artery Bypass Grafting: A Randomized Double Blind Controlled Trial

Background: Postoperative sternal pain is one of the most important factors affecting patients’ quality of life during the early post-operative days. Optimal pain management after cardiac surgery improve comfort and well...

Chronic back pain: A society primed for pain with an emphasis on passive treatments

The article published on the July 31, 2018 issue of the New York Times science section, “After Doctors Cut Their Opioids, Patients Turn to a Risky Treatment for Back Pain” raises several thoughtful and concerning issues...

Neuropathic pain due to chronic idiopathic axonal neuropathy: fast pain reduction after topical phenytoin cream application

Pain due to chronic idiopathic axonal polyneuropathy (CIAP) is often treated with therapies based on general neuropathic pain guidelines, which are mainly developed with randomized clinical trials having valuated treatme...

Kambo: A ritualistic healing substance from an Amazonian frog and a source of new treatments

Kambo is the name of a complex mixture of a number of bioactive peptides, secreted via the skin of a tropical frog, Phyllomedusa bicolor. Since centuries this secretion is harvested from the living animal by members of t...

Case Study: Local Anesthetic Toxicity After Bier Block. Was intralipid Therapy the Correct Remedy

Introduction: Intralipid therapy is recommended for patients with local anesthetics like Bupivacaine, but it is not advisable for patients with short acting local anesthetic toxicity like Lidocaine. Presentation of case:...

Download PDF file
  • EP ID EP559476
  • DOI 10.17352/ojpm.000005
  • Views 28
  • Downloads 0

How To Cite

Bujedo Borja Mugabure (2017). Physiology of Spinal Opioids and its relevance for Pain Management Selection. Open Journal of Pain Medicine, 1(1), 21-26. https://europub.co.uk/articles/-A-559476