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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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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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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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Analgesia and Pain Management01:25

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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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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Articles linked to this work by shared authors, journal, and citation graph.

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Updated: Jun 3, 2025

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Opioid-Sparing Protocols in Hand Surgery: Successes and Opportunities.

Jonathan Lawson1, Michael Grzelak2, Roland Zama2

  • 1The Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD; Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA.

The Journal of Hand Surgery
|January 11, 2025
PubMed
Summary
This summary is machine-generated.

Opioid-sparing pain management shows promise in hand surgery, especially for outpatient procedures. Further research is needed for complex surgeries and to identify patients needing enhanced pain control.

Keywords:
Hand surgeryopioid epidemicopioid regimenopioid sparingopioids

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Public Health

Background:

  • The opioid epidemic remains a critical public health issue in the United States.
  • Previous interventions, including legislation and educational initiatives, have yielded mixed results in curbing opioid misuse.
  • Hand surgery is exploring opioid-sparing strategies to manage postoperative pain.

Purpose of the Study:

  • To review the progress and challenges of opioid-sparing pain management protocols in hand surgery.
  • To identify areas for future research and development in postoperative pain control.

Main Methods:

  • Review of current literature on opioid-sparing regimens in hand surgery.
  • Analysis of successes and limitations of nonopioid and limited-opioid protocols.
  • Examination of data gaps for complex procedures and patient populations.

Main Results:

  • Opioid-sparing protocols show potential, particularly for ambulatory soft tissue procedures.
  • Challenges include limited data for bony and complex soft tissue surgeries.
  • Existing protocols may lack diversity and sometimes prove inadequate.

Conclusions:

  • Opioid-sparing regimens are a promising avenue for postoperative pain management in hand surgery.
  • Further investigation is required for complex procedures and to identify at-risk patients.
  • Development of tailored, comprehensive pain management strategies is essential.