ABSTRACT
The abuse of opioids in the perioperative period has made the side effects of opioids increasingly prominent. So many anesthesiologists have proposed the concept of opioid-free anesthesia. Immunomodulation is an important field of modern medical research. With the introduction of the concept of enhanced recovery after surgery, the immunomodulatory effects of opioids have received increasing attention. Currently, the fentanyl family is commonly used opioid analgesics in clinical practice. This article reviews the research progress of the fentanyl family and immunomodulation, in order to provide guidance for clinicians to choose analgesic drugs.
ABSTRACT
Chronic pain is a common clinical manifestation in patients with advanced cancer, and pain treatment is a part of cancer treatment. The titration method of opiod drugs will be recommended for relieving pain in moderate-severe pain in order to improve the quality of life of patients with advanced cancer. Individualized pain control refers to the concept that different patients show different resistance responses to opiod drugs. This article briefly reviews the classification and mechanism of cancer pain, the titration method of opiod drugs in the cancer pain control and individualized application.
ABSTRACT
Objective To assess the effect of opiod pretreatment on etomidate induced myoclonus. Methods The pertinent literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,and CHKD. Then the meta?analysis was performed by using RevMan 5.2 and STATA 12.0 software. Results A total of 24 RCTs involving 2 396 pa?tients were included for the study. Pretreatment ofμorκ?receptor agonists reduced myoclonus with RR=0.19(95%CI 0.14 to 0.27)and RR=0.22 (95%CI 0.12 to 0.40),respectively. Conclusion Pretreatment of opiods can reduce the incidence of etomidate induced myoclonus.
ABSTRACT
Morphine is a potent analgesic opioid used extensively for pain treatment. During the last decade, global consumption grew more than 4-fold. However, molecular mechanisms elicited by morphine are not totally understood. Thus, a growing literature indicates that there are additional actions to the analgesic effect. Previous studies about morphine and oxidative stress are controversial and used concentrations outside the range of clinical practice. Therefore, in this study, we hypothesized that a therapeutic concentration of morphine (1 μM) would show a protective effect in a traditional model of oxidative stress. We exposed the C6 glioma cell line to hydrogen peroxide (H2O2) and/or morphine for 24 h and evaluated cell viability, lipid peroxidation, and levels of sulfhydryl groups (an indicator of the redox state of the cell). Morphine did not prevent the decrease in cell viability provoked by H2O2 but partially prevented lipid peroxidation caused by 0.0025% H2O2 (a concentration allowing more than 90% cell viability). Interestingly, this opioid did not alter the increased levels of sulfhydryl groups produced by exposure to 0.0025% H2O2, opening the possibility that alternative molecular mechanisms (a direct scavenging activity or the inhibition of NAPDH oxidase) may explain the protective effect registered in the lipid peroxidation assay. Our results demonstrate, for the first time, that morphine in usual analgesic doses may contribute to minimizing oxidative stress in cells of glial origin. This study supports the importance of employing concentrations similar to those used in clinical practice for a better approximation between experimental models and the clinical setting.
Subject(s)
Animals , Rats , Analgesics, Opioid/pharmacology , Glioma/drug therapy , Hydrogen Peroxide/administration & dosage , Morphine/pharmacology , Oxidative Stress/drug effects , Cell Line, Tumor , Cell Survival , Free Radical Scavengers/pharmacology , Glioma/metabolism , Lipid Peroxidation/drug effects , Models, Biological , Morphine/administration & dosage , Oxidation-Reduction , Protective Factors , Sulfhydryl Compounds/analysisABSTRACT
62 patients with opiod poisoning involved our study were treated by naloxon and respiratory supportive therapies as united protocol. Because of aggressive using naloxon, the ratio of patients requiring intubations and mechanical ventilation was significantly decreased, 29% and 17.7% respectively. The manifestation of opiod overdose were rapidly improved and almost of the patients (95.5%) were treated successfully. The side effects of naxolon were minor. We observed only 2 cases having vomiting after Iv injection of naloxon. Ambuballon bagging with 100% oxygen was mainly respiratory supportive therapy. The mechanical ventilation indicated for the patients suffering from life-threatening respiratory failure. Heroin-induced pulmonary edema accounted for 82% of these cases. PEEP was used in 7 patients. The mean of PEEP levels was 5.31.3 cmH2O. Our protocol was success in 95.5%.