Despite compelling evidence for the safety and efficacy of intrathecal hydromorphone, the use of this opioid intrathecally for the pain management of patients undergoing cesarean delivery has not been widely accepted. The purpose of this retrospective study was to compare the reported efficacy and safety of pain management in women who received intrathecal hydromorphone (100 microg) vs in women who received intrathecal fentanyl (25 microg) or a local anesthetic for their cesarean delivery. The author hypothesized that intrathecal hydromorphone because of its known pharmacodynamics would provide better postoperative analgesia within the first 24 hours after cesarean delivery. The results of this retrospective chart review confirmed the hypothesis that intrathecal hydromorphone possesses the appropriate pharmacodynamics to facilitate optimal pain relief in patients undergoing cesarean delivery. It provided a comparable onset of effective pain relief, as well as a significantly prolonged duration of pain relief (P < .001) compared with intrathecal fentanyl or local anesthetic. Traditionally, intrathecal morphine was the opioid of choice for prolonged pain management during cesarean deliveries in which spinal anesthesia was selected. However, intrathecal hydromorphone was shown to be an effective and possibly even better substitute. Further research on intrathecal hydromorphone is needed.
[Show abstract][Hide abstract] ABSTRACT: This paper is the thirty-sixth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2013 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia; stress and social status; tolerance and dependence; learning and memory; eating and drinking; alcohol and drugs of abuse; sexual activity and hormones, pregnancy, development and endocrinology; mental illness and mood; seizures and neurologic disorders; electrical-related activity and neurophysiology; general activity and locomotion; gastrointestinal, renal and hepatic functions; cardiovascular responses; respiration and thermoregulation; and immunological responses.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.