Abstract

MUGABURE BUJEDO, B. Key factors influencing bioavailability of opioides in the spinal cord for the management of acute pain. Rev. Soc. Esp. Dolor [online]. 2019, vol.26, n.6, pp.359-367.  Epub Mar 30, 2020. ISSN 1134-8046.  https://dx.doi.org/10.20986/resed.2019.3737/2019.

Although there is no either ideal analgesic or route of neuraxial administration, clinicians alike continue to search for compounds with qualities which may approach this idea. However, it´s a demonstrated fact that spinal administration of an opioid drug does not always guarantee segmental and selective analgesia into the spinal cord. This point is valid due to partial reuptake of the drug to systemic blood circulation reaching specific brain opioid receptors, rather than the differences are explained by variations in the clearance rate from the cerebrospinal fluid. Published evidence from either human or animal experimental studies indicates that bioavailability in the spinal cord biophase is negatively correlated with liposolubility. Therefore, opioid spinal cord bioavailability is higher for hydrophilic opioids like morphine, than for lipophilic ones such as fentanyl, sufentanil or alfentanil.

Keywords : Analgesics; opioids; biological availability; opioid receptors; acute pain; spinal cord.

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