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奥昔哌啶用于治疗中重度急性术后疼痛的管理:叙事性综述。

Oliceridine for the Management of Moderate to Severe Acute Postoperative Pain: A Narrative Review.

机构信息

Department of Anesthesiology, Stony Brook University Health Science Center, Stony Brook, NY, 11794-8480, USA.

Department of Neurosurgery, Stony Brook University Health Science Center, Stony Brook, NY, 11794-8480, USA.

出版信息

Drug Des Devel Ther. 2023 Mar 22;17:875-886. doi: 10.2147/DDDT.S372612. eCollection 2023.

Abstract

Despite current advances in acute postoperative pain management, prevalence remains high. Inadequate treatment could lead to poor outcomes and even progression to chronic pain. Opioids have traditionally been the mainstay for treatment of moderate to severe acute pain. However, their use has been associated with opioid-related adverse events (ORAEs), such as respiratory depression, sedation, nausea, vomiting, pruritus, and decreased bowel motility. In addition, their liberal use has been implicated in the current opioid epidemic. As a result, there has been renewed interest in multimodal analgesia to target different mechanisms of action in order to achieve a synergistic effect and minimize opioid usage. Oliceridine is a novel mu-opioid receptor agonist that is part of a new class of biased ligands that selectively activate G-protein signaling and downregulate β-arrestin recruitment. Since G-protein signaling has been associated with analgesia while β-arrestin recruitment has been associated with ORAEs, there is potential for a wider therapeutic window. In this review, we will discuss the clinical evidence behind oliceridine and its potential role in acute postoperative pain management. We have systematically searched the PubMed database using the keywords , and . All articles identified were reviewed and evaluated, and all clinical trials were included.

摘要

尽管目前在急性术后疼痛管理方面取得了进展,但患病率仍然很高。治疗不当可能导致不良后果,甚至发展为慢性疼痛。阿片类药物一直是治疗中重度急性疼痛的主要药物。然而,它们的使用与阿片类药物相关的不良反应(ORAEs)有关,如呼吸抑制、镇静、恶心、呕吐、瘙痒和肠蠕动减少。此外,它们的广泛使用与当前的阿片类药物流行有关。因此,人们重新对多模式镇痛产生了兴趣,以针对不同的作用机制,以达到协同效应并最小化阿片类药物的使用。奥立利定是一种新型的μ-阿片受体激动剂,属于新型的偏向配体之一,选择性激活 G 蛋白信号传导并下调β-arrestin 募集。由于 G 蛋白信号与镇痛有关,而β-arrestin 募集与 ORAEs 有关,因此可能存在更宽的治疗窗口。在这篇综述中,我们将讨论奥立利定的临床证据及其在急性术后疼痛管理中的潜在作用。我们使用关键词 在 PubMed 数据库中进行了系统搜索 , 。所有确定的文章都进行了审查和评估,所有临床试验都包括在内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fc5/10040154/e7a7e620fa0c/DDDT-17-875-g0001.jpg

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