Open Access Review Article Article ID: OJPM-1-105

    Physiology of Spinal Opioids and its relevance for Pain Management Selection

    Borja Mugabure Bujedo*

        To use spinal opioids appropriately, it is necessary to understand the pharmacokinetics and clinical pharmacology of these drugs including which opioids produce selective spinal analgesia and which do not. Briefl y, spinal selectivity is highest for hydrophilic opioids and lowest for lipophilic opioids. These differences result from natural variations in the bioavailability of opioids at opioid receptors in the spinal cord. The bioavailability differs because lipophilic drugs are more rapidly cleared into the plasma from epidural and intrathecal spaces, than hydrophilic drugs; consequently, they produce earlier supraspinal side effects and have a considerably shorter duration of analgesic action concerning morphine which can produce delay supraspinal adverse effects.

           Morphine is probably the most spinally selective opioid currently used in the intrathecal and epidural spaces for the management of postoperative pain. Continuous epidural administration of fentanyl offers little or no benefi t over the intravenous route. Finally, epidurally administered sufentanil and alfentanil   appear to produce analgesia by systemic uptake and redistribution to brainstem opioid receptors.


    Published on: Jun 15, 2017 Pages: 21-26

    Full Text PDF Full Text HTML DOI: 10.17352/ojpm.000005
    CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat


    Global Views

    Case Reports

    Peertechz Tweets

    Pinterest on OJPM

    Google Reviews 11