Understanding the physiology and pharmacology of epidural and intrathecal opioids.
Understanding the physiology and pharmacology of epidural and intrathecal opioids.
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DOI：
10.1053/bean.2002.0255
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发表时间：
2002-12-01
期刊：
影响因子：
--
通讯作者：
Bernards, Christopher M
中科院分区：
文献类型：
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作者：
Bernards, Christopher M
硬膜外和鞘内阿片类药物给药已成为现代医学实践中各种临床环境的重要组成部分。人们普遍认为，任何阿片样物质放置在硬膜外或鞘内空间将产生高度选择性的脊髓介导的镇痛，这是上级的其他镇痛技术所产生的。不幸的是，这根本不是真的。事实上，尽管临床证据表明脊髓给药不产生具有选择性脊髓机制的镇痛作用，或者所产生的镇痛作用并不上级于静脉内给药，但目前多种阿片样物质被用于脊髓给药。本章介绍了基础科学和临床数据，以帮助临床医生确定哪些阿片类药物适用于脊柱使用，哪些不适用。
Epidural and intrathecal opioid administration has become an important part of contemporary medical practice in a variety of clinical settings. It has been widely assumed that any opioid placed in the epidural or intrathecal spaces will produce highly selective spinally mediated analgesia that is superior to that produced by other analgesic techniques. Unfortunately, this is simply not true. In fact, multiple opioids are currently employed for spinal use despite the fact that clinical evidence has shown that spinal administration does not produce analgesia with a selective spinal mechanism or that the analgesia produced is not superior to that produced by intravenous administration. This chapter presents the basic science and clinical data available to assist clinicians in identifying which opioids are appropriate for spinal use and which are not.