Postoperative Epidural Opioids [Paperback]

Epidural opioids are widely used in the management of post-operative pain. On the basis of an extensive review of theliterature the authors here present their own interpretationof current knowledge of howthe distribution and effectiveness of epidurallyadministeredopiods are fundamentally determined.They conclude that all opioids that arecurrently being used to treat postoperative epidural paincarry the potential risk of severeside effects if the dose regimens are not tailored to thepatient`s individual analgesic need.This book will serve to stimulate new ideas among painspecialistst.Epidural opioids are widely used in the management of post-operative pain. On the basis of an extensive review of theliterature the authors here present their own interpretationof current knowledge of howthe distribution and effectiveness of epidurallyadministeredopiods are fundamentally determined.They conclude that all opioids that arecurrently being used to treat postoperative epidural paincarry the potential risk of severeside effects if the dose regimens are not tailored to thepatient`s individual analgesic need.This book will serve to stimulate new ideas among painspecialistst.Epidural and Intrathecal Space.- Anatomy.- Puncture of the Meninges.- Distribution of Solutions.- Determinants of Opioid Activity.- Physicochemical Properties.- Distribution and Elimination.- Opioid Receptors.- Supraspinal Receptor Sites.- Spinal Receptor Sites.- Receptor Affinities.- Receptor Binding Kinetics.- Opioid Pharmacokinetics After Epidural Administration.- Transfer Across the Meninges.- Uptake into the CSF.- Distribution within the CSF.- Elimination from CSF.- Uptake into Spinal Cord and Brain.- Uptake into Epidural Fat.- Vascular Uptake into the Systemic Circulation.- Following Epidural Bolus Injections.- During Continuous Epidural Opioid Treatment.- Elimination from Blood.- Summary.- Clinical Implications.- Onset Time of Analgesia.l#