Epidural Opioids in Postoperative Pain Treatment

Abstract

Analgesia by specific nociceptive block following spinal and epidural opioid injections has generated widespread interest. Early reports validated the clinical efficacy of these methods, but morphine in particular has been associated with unexpected, adverse side effects. Most of the clinical studies have progressed as though all the basic information on drug and patient variables had already been determined, whereas in fact, our knowledge is only inferential, derived from the use of epidural local anesthetic drugs or systemic narcotics. In order to understand the use of epidural opioids better, it is increasingly important to examine the factors which might influence the kinetics and dynamics of drugs given via this route.