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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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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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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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.
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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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gabapentin 可能不会降低阿片类药物的使用在儿科手术后增强康复手术协议后.

Hae Sung Kang1, Travis M Sullivan1, Rebecca Zee2

  • 1Department of Surgery, Virginia Commonwealth University, Richmond, Virginia.

The Journal of surgical research
|November 4, 2024
PubMed
概括
此摘要是机器生成的。

在儿科手术中使用 gabapentin 并没有减少阿片类药物消费,并且与增加的氧气需求有关. 需要进一步的研究来评估加巴丁在儿科手术后增强恢复 (ERAS) 协议中的作用.

关键词:
手术后更好的康复 术后更好的康复gabapentin 是一种药物.儿科 儿科 儿科呼吸系统缺陷 呼吸系统缺陷

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科学领域:

  • 麻醉学 麻醉学
  • 儿科手术 儿科手术
  • 药理学 药理学是指药理学的学科.

背景情况:

  • 在成人手术后增强恢复 (ERAS) 协议中使用 gabapentin 与较高的发病率和最小的疼痛缓解有关.
  • 在儿科ERAS协议中对 gabapentin 的疗效和安全性存在有限的数据.

研究的目的:

  • 调查加巴丁的使用与在接受选择性手术的儿童手术后的结果之间的关联.
  • 评估 gabapentin 对阿片类药物消费和其他临床结果的影响.

主要方法:

  • 对196名接受选择性整体,泌尿外科或骨科手术的儿科患者进行了回顾性研究.
  • 对接受 gabapentin 与未接受 gabapentin 的患者进行比较,包括单变量,多变量和倾向分数匹配分析.
  • 从2018年1月到2021年9月收集的数据,在 gabapentin 从机构ERAS协议中被删除后.

主要成果:

  • 当与阿片类药物联合使用时, gabapentin 与减少阿片类药物消费没有相关性.
  • 接受 gabapentin 的儿童需要补充氧气的几率更高,尽管在倾向分数匹配后,这并不显著.
  • 在 gabapentin 使用和手术后麻醉剂使用减少之间没有发现显著的关联.

结论:

  • 在多式儿科疼痛治疗方案中, gabapentin 没有降低术后阿片类药物使用.
  • 建议进行进一步的前性研究,以评估 gabapentin 在儿科外科手术期间疼痛管理中的作用.
  • 加巴丁在儿科ERAS协议中的实用性需要进一步调查.