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Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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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Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

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...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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General Anesthesia: Overview

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Related Experiment Videos

Respiratory Depression after Perioperative Methadone Administration: A Systematic Review and Meta-analysis.

Eduardo Nunez-Rodriguez1,2, Guido Mazzinari3,4, Sarah Lumsden2,5

  • 1From the Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Houston, Texas.

Anesthesia and Analgesia
|May 8, 2026
PubMed
Summary

Perioperative intravenous methadone did not show a higher risk of respiratory depression compared to other opioids. Further prospective studies with rigorous monitoring are needed to confirm the safety of intravenous methadone in surgical patients.

Related Experiment Videos

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Perioperative methadone use is limited by concerns about respiratory depression.
  • Evidence supports methadone's analgesic efficacy.
  • This study evaluates the association between perioperative IV methadone and postoperative respiratory depression.

Purpose of the Study:

  • To objectively evaluate the current evidence on the association between perioperative intravenous methadone administration and postoperative respiratory depression.
  • To compare the risk of respiratory depression with other opioids.

Main Methods:

  • Systematic review and meta-analysis of RCTs and retrospective studies.
  • Searched Ovid MEDLINE, Embase, CENTRAL, and Scopus.
  • Primary outcome: postoperative respiratory depression (naloxone use, RR <8, SpO2 <90%).

Main Results:

  • 25 studies with 116,815 patients included.
  • Methadone not associated with significantly greater risk of respiratory depression (RR 1.22, 95% CI 0.76-1.95).
  • Evidence certainty was very low due to bias and lack of continuous monitoring.

Conclusions:

  • Perioperative intravenous methadone was not associated with increased respiratory depression risk compared to other opioids.
  • Current evidence is mainly from retrospective data.
  • Prospective studies with rigorous monitoring are needed to validate safety.