			Home About us Contact

Systemic Opioids (systemic + opioid)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Analgesia for labour: a survey of Norwegian practice , with a focus on parenteral opioids

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2009
T. O. TVEIT
Background: During the last two decades, epidural analgesia has become ,a gold standard' for labour pain in most Western countries. Newer short-acting opioids given systemically represent an alternative for adequate pain relief without using regional techniques. With this survey, we wish to explore how Norwegian hospitals practice labour analgesia, especially their use of systemic opioids. Methods: A questionnaire was sent to the head of all 46 registered Norwegian labour units in 2005. The questionnaire focused on epidural and the use of systemic opioids. In 2008, the same questionnaire was sent to the 19 largest units reporting >1000 births a year, seeking updated information. Results: Forty-three of the 46 original questionnaires were returned. An epidural frequency of 25.9% was registered. For epidural treatment, bupivacaine was the preferred local anaesthetic, while sufentanil was the opioid of choice for the majority of units. Pethidine was the most commonly used opioid for systemic administration (77%). All units reported nurse administration of systemic opioids. The intramuscular route was most commonly used, either alone (58%) or in combination with an intravenous (i.v.) administration (34%). Only one unit used i.v. fentanyl. There were only minor changes with the repeated survey, except for one large unit, which reported over a 50% increase in the epidural frequency. Conclusion: In Norway, the frequency of epidural for labour analgesia is still relatively low, but seems to be increasing. Systemic opioids are often used instead of or as a supplement. Clinical practice seems to be conservative, and newer short-acting opioids are seldom used systemically. [source]

Opioids in neuropathic pain

JOURNAL OF NEUROCHEMISTRY, Issue 2003
R. Przew
Neuropathic pain in human appears not to be opioid-resistant but only reduced sensitivity to systemic opioids is observed in this condition. We studied the contribution of central and peripheral mu-opioid receptors to the antinociception in rats with a spinal nerve ligation-induced neuropathy. Results of the present study indicate that both spinal and peripheral opioid receptors may contribute to the opioid-induced antinociception in the neuropathy. Further, mu-opioid peptide ligands (DAMGO and endomorphins) are more effective than opioid alkaloids in relieving of neuropathic pain. Moreover, reduction of the mu-opioid antinociceptive potency appears to be due to the fact that nerve injury reduced expression of mu-opioid receptors in the spinal ganglia. Identification of the molecular mechanisms involved may be of importance to the understanding of the molecular mechanism of opioid action in neuropathic pain, as well as to the development of better and more effective treatment of neuropathic pain in humans. [source]

Addition of clonidine and fentanyl: comparison between three different regional anesthetic techniques in circumcision

PEDIATRIC ANESTHESIA, Issue 11 2005
ZOUHER A NAJA MD
Summary Background :,Several techniques have been used for alleviating postcircumcision pain with regional anesthetics being more effective than systemic opioids. Our aim was to compare the effectiveness of dorsal penile block, ring block (RB) and dorsal penile block associated with RB in reducing postcircumcision pain in children. Methods :,We conducted a prospective randomized double-blind clinical trial on 100 boys aged between 1 month and 5 years undergoing elective circumcision. Each 20 ml of local anesthetic mixture contained 9 ml lidocaine 1% without epinephrine, 9 ml bupivacaine 0.5%, 1 ml fentanyl (50 ,g·ml,1) and 1 ml clonidine (75 ,g·ml,1). They were allocated to one of three groups: 33 boys were given a RB with 1,1.5 ml (group 1), 32 had a dorsal penile block with 1.5,4 ml (group 2) and 35 had a combined ring and dorsal penile block with 2.5,5 ml of anesthetic mixture based on the child's age. Results :,Ninety-one children (91%) completed the clinical trial (three failed blocks and six follow-up losses). The groups were similar with regard to age, weight, height, duration of surgery and hemodynamic status. The average pain scores were significantly higher with a RB compared with the other two groups (P < 0.05) for the first postoperative day. RB children and dorsal penile block children consumed significantly more analgesics for the first six postoperative hours (P < 0.05). The surgeon's satisfaction was significantly higher with the ring + dorsal penile block group (100%) compared with the other two groups (P = 0.032). Conclusion :,Dorsal penile block plus RB technique is superior to dorsal penile block alone and RB alone in reducing postcircumcision pain in children. [source]