Single-Injection
Single-injection of neuraxial opioids are preferred over parentral opioids) .Single-injection neuraxial; fentanyl and sufentanil areprefered over morphine and hydromorphone .concomitant administration of sedatives, hypnotics,or magnesium and parenteral opioids,require therapeutic drug monitoring.
IV PCA morphine is better than intramuscular morphine.Various modes of analgesia are often equianalgesic but for the inscidence of Advers drug reactions. it is a preferred strategy to use background morphine when using IV PCA as it minimises the dosage of analgesic required. in ambulatory patients morphine is not the preferrd post operative analgesic.Use of Fentanyl causes minimal cortical depression,prolonged respiratory alteration with minimal …show more content…
tramadol can be used for mild to moderate pain, and morphine is the choice for severeand intractable pain. the higher plasma concentration of oxycodone is due to greater clearance of morphine, in the study where analgesics were given in ventilated patients.Such differential pharmacokinetics makes for optimal choice. The parenteral routes is comonnoly used but it is beset with pain and other adverse drug reactions.
Perioperative analgesics are provided in lower dosages in elderly patients as they are more prone to adverse effects.there is still lacunae in the optimal analgesic therapy in geriartrics as often times they are undertreated
COMBINATION OF OPIOIDS: better compliance can be fostered by using effective , rational combinations(opioid+NSAID/ GABA analogs) , reducing pill burdern , dosing convienece and reduced adverse reactions. Synergistic analgesic benefits have been noted with opioid+NSAID(30-40%). / GABA analogs combination,due to opioid sparing effect33 that allows better analgesia at low doses of opioid.
The investigators have arrived at the recommendations which should be kept in mind in the choice of an optimal
IV PCA morphine is better than intramuscular morphine.Various modes of analgesia are often equianalgesic but for the inscidence of Advers drug reactions. it is a preferred strategy to use background morphine when using IV PCA as it minimises the dosage of analgesic required. in ambulatory patients morphine is not the preferrd post operative analgesic.Use of Fentanyl causes minimal cortical depression,prolonged respiratory alteration with minimal …show more content…
tramadol can be used for mild to moderate pain, and morphine is the choice for severeand intractable pain. the higher plasma concentration of oxycodone is due to greater clearance of morphine, in the study where analgesics were given in ventilated patients.Such differential pharmacokinetics makes for optimal choice. The parenteral routes is comonnoly used but it is beset with pain and other adverse drug reactions.
Perioperative analgesics are provided in lower dosages in elderly patients as they are more prone to adverse effects.there is still lacunae in the optimal analgesic therapy in geriartrics as often times they are undertreated
COMBINATION OF OPIOIDS: better compliance can be fostered by using effective , rational combinations(opioid+NSAID/ GABA analogs) , reducing pill burdern , dosing convienece and reduced adverse reactions. Synergistic analgesic benefits have been noted with opioid+NSAID(30-40%). / GABA analogs combination,due to opioid sparing effect33 that allows better analgesia at low doses of opioid.
The investigators have arrived at the recommendations which should be kept in mind in the choice of an optimal