University of Oslo, Oslo University Hospital, Department of Anesthesiology, and Medical Faculty , P.box 4950 Nydalen, N-0424 Oslo , Norway +4722119690; +4792249669 ; +4722119857 ;
Expert Opin Pharmacother. 2014 Mar;15(4):449-52. doi: 10.1517/14656566.2014.879292. Epub 2014 Jan 17.
New approved options with opioids in the postoperative setting may include new ways of administration, new combinations with other drugs and new opioid drugs. Newly approved devices for administration include sublingual sufentanil dispenser and transdermal iontophoretic fentanyl, with the purpose of almost mimicking the rapid and reliable onset of intravenous (IV) administration, without the problems of an ongoing IV cannula and cumbersome equipment. Still, potential problems of overdosing and misuse must be in focus when these devices come into use. Tapentadol is a new partial µ-receptor opioid agonist with a combined action on norepinephrine-induced analgesia, representing a promising drug in terms of less side effects at equianalgesic doses compared with pure agonists. The mixture of different opioids given together, such as oxycodone and morphine, for oral use may also have some analgesic synergy with an improved side-effect profile, although more studies are needed. Oral oxycodone is a reliable oral opioid option, but when combined with paracetamol in the same tablet or mixture, care should also be taken to avoid serious side effects from inadvertent paracetamol overdose.
新批准的术后阿片类药物选择可能包括新的给药方式、与其他药物的新组合以及新的阿片类药物。新批准的给药装置包括舌下芬太尼分配器和经皮离子电渗芬太尼，目的是几乎模拟静脉（IV）给药的快速可靠起效，而没有持续的 IV 套管和繁琐设备的问题。尽管如此，当这些设备投入使用时，必须关注潜在的用药过量和误用问题。他喷他多是一种新的部分μ-受体阿片类激动剂，具有对去甲肾上腺素诱导的镇痛的联合作用，与纯激动剂相比，在等效镇痛剂量下具有较少的副作用，代表着一种有前途的药物。不同阿片类药物的混合给药，如口服的羟考酮和吗啡，也可能具有一定的镇痛协同作用，并改善不良反应谱，尽管还需要更多的研究。口服羟考酮是一种可靠的口服阿片类药物选择，但当与对乙酰氨基酚在同一片剂或混合物中使用时，也应注意避免因意外过量使用对乙酰氨基酚而产生严重的副作用。
