IntrathecalNarcotics

IntrathecalNarcotics - Intrathecal Narcotics for Post-...

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Unformatted text preview: Intrathecal Narcotics for Post- operative Analgesia Kristopher R Davignon, MD Dept of Anessthesia Grand Rounds March 2007 Intrathecal Narcotics • Opioids were know to the ancient Sumerians as of 4000 B.C. • 1971 Opioid receptor discovered • 1973 Receptors found in the brain • 1976 Receptors found in the spinal cord • 1979 Early reports of intrathecal opioids producing analgesia Intrathecal Narcotics • Thoracic and Upper Abdominal Procedures • Elective Total Hip Arthroplasty • 350,000 Procedures per year in the US • + 5 min to consent • + 15 min for procedure Overview and Goals • Anatomy, Physiology & Pharmacology • Complications • Evidence Based Practice • Dose-Response • Future Directions Anatomy, Physiology & Pharmacology Anatomy, Physiology & Pharmacology • Drug disposition depends primarily on lipid solubility • Any drug rapidly redistributes • opioid is detectable in the cisterna magna within 30 min of lumbar intrathecal administration Anatomy, Physiology & Pharmacology • Opiods • Morphine • Meperidine • Hydromorphone • Sufentanil & Fentanyl • Methadone • Non Opiods • Clonidine • Neostigmine • Adenosine • Epinephrine • Ketorolac • Midazolam Preservative Anatomy, Physiology &...
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This note was uploaded on 12/28/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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IntrathecalNarcotics - Intrathecal Narcotics for Post-...

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