関連する実験動画
Updated: Sep 9, 2025

14:56
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
21.5K
帝王切開後の痛みを軽減するための多式鎮痛療法におけるオピオイド使用の見直し
Gerrard Ferreira1, Tamara Lebedevs2, Stephanie Wai Khuan Teoh3
1King Edward Memorial Hospital, Subiaco, Perth, Western Australia.
Journal of opioid management
|September 4, 2025
まとめ
帝王切開の痛み管理に関するこの研究では,非選択的古典的な帝王切開の手術では,オピオイドの使用量が著しく高かったことが判明しました. 大半の患者は,CS後にオピオイドを投与され,3日間の供給で退院しました.
科学分野:
- 産婦人科
- 痛みの管理
- 薬理学について
背景:
- 帝王切開 (CS) は一般的な手術である.
- 効果的な疼痛管理はCSの産後回復に不可欠です.
- オピオイド鎮痛剤は,手術後の痛みの制御のために頻繁に使用されます.
研究 の 目的:
- 帝王切開後の患者の疼痛管理のためのオピオイド鎮痛剤の利用を評価する.
- 異なるタイプの帝王切開手術における オピオイド摂取量を比較する
- オピオイドの投与パターンを分析する
主な方法:
- 2022年9月に実施された帝王切開の遡及コホート監査.
- 患者の人口統計,使用したオピオイド薬,出院処方箋に関する医療記録のレビュー
- モルヒネ相当のオピオイドの総使用量の計算と一般的な排出薬の分析
主要な成果:
- 非選択的古典的CS (NEClassicalCS) 処置では,非選択的下部子宮CS (NELUSCS) (92. 4 mg) と選択的下部子宮CS (ELUSCS) (60. 1 mg) と比較して,モルヒネ相当のオピオイド使用量が高かった (平均245. 7 mg).
- トラマドールは出院時に最も頻繁に処方されたオピオイド (85%),次にブプレノルフィン (17%) とオキシコドン/ナロクソン (15%) でした.
- すべての患者はCS後の最初のオピオイド治療を受け,その93%は少なくとも1つのオピオイドで退院し,通常は平均3日間でした.
結論:
- 非選択的な古典的なCSは,オピオイドの痛み止めの必要性の増加と関連しています.
- 術後オピオイド投与は全ての帝王切開患者の標準的な処置です.
- トラマドールが最も多く使用されている.
さらに関連する動画
関連する概念動画
Opioid Analgesics: Synthetic and Semisynthetic Opioids
419
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...
419
Analgesia and Pain Management
788
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...
788
Opioid Analgesics: Morphine and Other Natural Cogeners
360
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...
360
Local Anesthetics: Clinical Application as Epidural Anesthesia
497
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.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
497
Parenteral Anesthetics: Overview
196
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.
196
Opioid Receptors: Overview
1.8K
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,...
1.8K

