<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1134-8046</journal-id>
<journal-title><![CDATA[Revista de la Sociedad Española del Dolor]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Soc. Esp. Dolor]]></abbrev-journal-title>
<issn>1134-8046</issn>
<publisher>
<publisher-name><![CDATA[Inspira Network Group, S.L ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1134-80462019000600008</article-id>
<article-id pub-id-type="doi">10.20986/resed.2019.3737/2019</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores clave que afectan a la biodisponibilidad de los opioides sobre la médula espinal en el manejo del dolor agudo]]></article-title>
<article-title xml:lang="en"><![CDATA[Key factors influencing bioavailability of opioides in the spinal cord for the management of acute pain]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mugabure Bujedo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario de Donostia Departamento de Anestesiología, Cuidados Críticos y Medicina del Dolor Unidad del dolor, Manejo del dolor agudo y crónico]]></institution>
<addr-line><![CDATA[San Sebastián ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2019</year>
</pub-date>
<volume>26</volume>
<numero>6</numero>
<fpage>359</fpage>
<lpage>367</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1134-80462019000600008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1134-80462019000600008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1134-80462019000600008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Aunque no existe un analgésico ni una vía de administración neuroaxial ideal, los clínicos continúan buscando compuestos con cualidades que puedan acercarse a esta idea. Sin embargo, se ha demostrado que la administración espinal de un medicamento opioide no siempre garantiza una analgesia segmentaria y selectiva en la médula espinal. Este punto es cierto debido a la recaptación parcial del fármaco a la circulación sistémica sanguínea que alcanza receptores opioides cerebrales específicos, además de las diferencias que se explican por las variaciones en la tasa de eliminación del líquido cefalorraquídeo. La evidencia publicada de estudios experimentales en humanos o animales indica que la biodisponibilidad en la biofase medular está correlacionada negativamente con la liposolubilidad. Por lo tanto, la analgesia espinal es mayor para los opioides hidrófilos como la morfina, que para los lipófilos como el fentanilo, el sufentanilo o el alfentanilo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT 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.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Analgésicos]]></kwd>
<kwd lng="es"><![CDATA[opioides]]></kwd>
<kwd lng="es"><![CDATA[biodisponibilidad medular]]></kwd>
<kwd lng="es"><![CDATA[receptores opioides]]></kwd>
<kwd lng="es"><![CDATA[dolor agudo]]></kwd>
<kwd lng="es"><![CDATA[médula espinal]]></kwd>
<kwd lng="en"><![CDATA[Analgesics]]></kwd>
<kwd lng="en"><![CDATA[opioids]]></kwd>
<kwd lng="en"><![CDATA[biological availability]]></kwd>
<kwd lng="en"><![CDATA[opioid receptors]]></kwd>
<kwd lng="en"><![CDATA[acute pain]]></kwd>
<kwd lng="en"><![CDATA[spinal cord]]></kwd>
</kwd-group>
</article-meta>
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