Depresión postoperatoria inducida por opioides
Postoperative opioide-induced respiratory depression
Anesthesiology News, October 2012
http://www.anesthesiologynews.com/download/SR1221_WM.pdf
Incidencia, reversión y prevención de la depresión respiratoria inducida por opioides
Incidence, Reversal, and Prevention of Opioid-induced Respiratory Depression.
Dahan A, Aarts L, Smith TW.
Department of Anesthesiology, Leiden University Medical Center, UK.a.dahan@lumc.nl
Anesthesiology. 2010 Jan;112(1):226-38.
Abstract
Opioid treatment of pain is generally safe with 0.5% or less events from respiratory depression. However, fatalities are regularly reported. The only treatment currently available to reverse opioid respiratory depression is by naloxone infusion. The efficacy of naloxone depends on its own pharmacological characteristics and on those (including receptor kinetics) of the opioid that needs reversal. Short elimination of naloxone and biophase equilibration half-lives and rapid receptor kinetics complicates reversal of high-affinity opioids. An opioid with high receptor affinity will require greater naloxone concentrations and/or a continuous infusion before reversal sets in compared with an opioid with lower receptor affinity. The clinical approach to severe opioid-induced respiratory depression is to titrate naloxone to effect and continue treatment by continuous infusion until chances for renarcotization have diminished. New approaches to prevent opioid respiratory depression without affecting analgesia have led to the experimental application of serotinine agonists, ampakines, and the antibiotic minocycline.
http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2010&issue=01000&article=00041&type=abstract
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Postoperative opioide-induced respiratory depression
Anesthesiology News, October 2012
http://www.anesthesiologynews.com/download/SR1221_WM.pdf
Incidencia, reversión y prevención de la depresión respiratoria inducida por opioides
Incidence, Reversal, and Prevention of Opioid-induced Respiratory Depression.
Dahan A, Aarts L, Smith TW.
Department of Anesthesiology, Leiden University Medical Center, UK.a.dahan@lumc.nl
Anesthesiology. 2010 Jan;112(1):226-38.
Abstract
Opioid treatment of pain is generally safe with 0.5% or less events from respiratory depression. However, fatalities are regularly reported. The only treatment currently available to reverse opioid respiratory depression is by naloxone infusion. The efficacy of naloxone depends on its own pharmacological characteristics and on those (including receptor kinetics) of the opioid that needs reversal. Short elimination of naloxone and biophase equilibration half-lives and rapid receptor kinetics complicates reversal of high-affinity opioids. An opioid with high receptor affinity will require greater naloxone concentrations and/or a continuous infusion before reversal sets in compared with an opioid with lower receptor affinity. The clinical approach to severe opioid-induced respiratory depression is to titrate naloxone to effect and continue treatment by continuous infusion until chances for renarcotization have diminished. New approaches to prevent opioid respiratory depression without affecting analgesia have led to the experimental application of serotinine agonists, ampakines, and the antibiotic minocycline.
http://journals.lww.com/anesthesiology/pages/articleviewer.aspx?year=2010&issue=01000&article=00041&type=abstract
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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