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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

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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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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Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

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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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创建一个框架,以尽量减少在办公室手术后的阿片类药物消费.

Austin A Skinner1, Vikranth R Chinthareddy2, Richard D Urman3

  • 1College of Osteopathic Medicine, Kansas City University, Joplin, MO, USA. austin.skinner@kansascity.edu.

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概括

门诊手术的增加需要一个框架来减少阿片类药物处方. 在所有手术阶段仔细规划可以提高患者的满意度,并尽量减少阿片类药物的使用.

关键词:
基于办公室的外科手术抗阿片类药物节省的止痛药.

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科学领域:

  • 手术创新 在外科创新.
  • 疼痛管理 疼痛管理
  • 公共卫生 公共卫生

背景情况:

  • 在美国,门诊外科手术的数量越来越多.
  • 财政激励推动门诊和办公室外科手术的增长.
  • 在办公室环境中缺乏经过手术后疼痛管理的安全指南.

研究的目的:

  • 审查阿片类药物处方和办公室手术的当前趋势.
  • 提出一个框架,以尽量减少阿片类药物的消费后程序.
  • 解决由于门诊程序增加而导致阿片类药物处方预期增加的问题.

主要方法:

  • 对近期阿片类药物处方趋势的系统审查.
  • 在办公室外科手术中影响阿片类药物消费的因素分析.
  • 为外科手术期间的疼痛管理制定框架.

主要成果:

  • 办公室外科手术是一个快速增长的行业,门诊手术的数量越来越多.
  • 对于在门诊环境中管理疼痛的指导方针存在不足.
  • 门诊程序的增加可能会导致在没有适当规划的情况下处方阿片类药物的增加.

结论:

  • 在办公室手术后,结构化的方法对于管理疼痛和阿片类药物使用至关重要.
  • 在每个操作阶段考虑系统因素是必不可少的.
  • 有效的规划可以提高患者的满意度,减少阿片类药物处方.