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评估奥利塞啶作为成人中重度急性术后疼痛的治疗选择。

Evaluating oliceridine as a treatment option for moderate to severe acute post-operative pain in adults.

机构信息

Department of Anesthesiology, Stony Brook University Health Science Center, Stony Brook, NY, USA.

Department of Neurosurgery, Stony Brook University Health Science Center, Stony Brook, NY, USA.

出版信息

Expert Opin Pharmacother. 2022 Jan;23(1):9-17. doi: 10.1080/14656566.2021.1982893. Epub 2021 Oct 20.

Abstract

INTRODUCTION

Despite the advances in regional anesthesia and non-opioid systemic analgesia, opioids remain the primary rescue analgesic for moderate to severe pain. However, the risks and side effects of opioid medications are well documented. Oliceridine is a novel opioid receptor agonist which is thought to have less risk of adverse events, such as postoperative nausea and vomiting (PONV) and respiratory depression.

AREAS COVERED

In this review, the authors discuss the limitations of the current opioid and non-opioid analgesic options. They also review the pharmacokinetics of oliceridine, its analgesic efficacy, and risk of adverse events; and its added clinical value in managing moderate to severe pain.

EXPERT OPINION

Despite the advances in regional anesthesia and multimodal systemic analgesia, opioid free analgesia is only feasible in selected procedures and patients. Oliceridine is effective in the management of moderate to severe pain and appears to be associated with lower risk of nausea and vomiting. The risk of sedation and respiratory depression associated with oliceridine will require further study. The availability of an opioid agonist with a better side effect profile could potentially change the current paradigm of opioid avoidance in postoperative pain management.

摘要

简介

尽管区域麻醉和非阿片类全身镇痛技术取得了进步,但阿片类药物仍然是中重度疼痛的主要解救性镇痛药物。然而,阿片类药物的风险和副作用已有充分记录。奥昔布宁是一种新型阿片受体激动剂,据认为其不良反应(如术后恶心和呕吐[PONV]和呼吸抑制)的风险较低。

涵盖领域

在这篇综述中,作者讨论了当前阿片类药物和非阿片类镇痛药物选择的局限性。他们还回顾了奥昔布宁的药代动力学、镇痛效果、不良反应风险及其在管理中重度疼痛方面的额外临床价值。

专家意见

尽管区域麻醉和多模式全身镇痛技术取得了进步,但在选定的手术和患者中,无阿片类药物镇痛才可行。奥昔布宁在中重度疼痛的管理中有效,且似乎与恶心和呕吐的风险较低相关。奥昔布宁引起镇静和呼吸抑制的风险需要进一步研究。具有更好的副作用特征的阿片类激动剂的出现可能会改变术后疼痛管理中目前避免使用阿片类药物的模式。

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