对药物治疗阿片类药物使用障碍的术后考虑:布普伦诺芬,甲或纳尔特雷
T Kyle Harrison1, Howard Kornfeld2, Anuj Kailash Aggarwal3
1Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University (Affiliated- PAVA), Staff Phyician Department of Anesthesiology, Perioperative and Pain Medicine VA Palo Alto Health Care System.
Anesthesiology clinics
|November 13, 2025
概括
阿片类药物使用障碍 (OUD) 影响了许多人,治疗机会有限. 了解OUD (MOUD) 的药物及其术后使用对于手术期间的患者安全至关重要.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 成 药物 药物 药物 药物
背景情况:
- 美国面临着持续的阿片类药物危机,2022年将有超过8万例阿片类药物相关死亡.
- 对于患有阿片类药物使用障碍 (OUD) 的人来说,仍然存在很大的治疗差距.
- 对OUD (MOUD) 的药物是有效的,但需要仔细的术后管理.
研究的目的:
- 突出了解MOUD药理学,剂量和外科手术期间策略的重要性.
- 为管理正在接受手术的OUD患者的临床医生提供指导.
- 为了改善治疗结果和患者在术后环境中的安全.
主要方法:
- 关于MOUD (甲,布普伦诺芬,纳尔特雷) 的当前文献的综述.
- 对MOUD的药理学概况和剂量考虑的分析.
- 对OUD患者的既定和新兴外科手术期间管理策略的检查.
主要成果:
- MOUD对于管理OUD至关重要,但存在独特的外科手术期间挑战.
- 特定的MOUD (甲,布普伦诺芬,纳尔特雷) 需要量身定制的麻醉和手术方法.
- 有效的术后管理可以减轻风险,并支持持续的OUD治疗.
结论:
- 临床医生必须对MOUD有充分的了解,以确保OUD患者的安全手术护理.
- 在外科手术期间优化MOUD管理对于降低死亡率和改善长期康复至关重要.
- 需要进一步的研究和临床指导方针来完善外科期间的MOUD协议.
更多相关视频
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
897
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...
897
Opioid Analgesics: Morphine and Other Natural Cogeners
833
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...
833
Analgesia and Pain Management
1.5K
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...
1.5K
Opioid Receptors: Overview
4.0K
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,...
4.0K
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
602
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
602
Parenteral Anesthetics: Overview
565
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.
565


