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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Opioid Receptors: Overview01:22

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Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Related Experiment Video

Updated: Aug 8, 2025

Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Developing expert international consensus statements for opioid-sparing analgesia using the Delphi method.

Daniel Da Der Sng1, Giulia Uitenbosch2, Hans D de Boer3

  • 1School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK. danielsng96@gmail.com.

BMC Anesthesiology
|February 28, 2023
PubMed
Summary

Opioid-sparing multimodal analgesia shows strong evidence but faces adoption barriers. Addressing education gaps and developing guidelines are key to increasing its use in postoperative pain management.

Keywords:
DelphiOpioid-sparingOpioids

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Area of Science:

  • Anesthesiology
  • Pain Management
  • Surgical Care

Background:

  • Postoperative pain management is evolving with multimodal analgesia.
  • Understanding motivations and barriers for opioid-sparing analgesia is crucial.

Purpose of the Study:

  • To explore expert anesthesiologists' perspectives on opioid-sparing multimodal analgesia.
  • To identify barriers and facilitators for adopting opioid-sparing analgesic strategies.

Main Methods:

  • Modified Delphi survey with 29 expert anesthesiologists.
  • Three-round questionnaire to determine consensus on multimodal analgesia.
  • Likert scale used to assess agreement and prioritize statements.

Main Results:

  • Consensus (over 75% agreement) reached on 5 out of 8 statements.
  • Strong evidence supports opioid-sparing multimodal analgesia.
  • Key barriers include lack of training, education, and resistance to practice change.

Conclusions:

  • Developing specific guidelines for multimodal analgesia is recommended.
  • Addressing educational gaps is vital for improving adoption.
  • Focusing on education and guidelines can enhance opioid-sparing analgesia implementation.