Lapis ISSN 2398-2969

Anesthesia: analgesia - opioids

Synonym(s): Opioid analgesia

Contributor(s): David Perpinan, Vladimir Jekl

Introduction

  • Opioid analgesics mimic the response of endogenous opioid peptides such as endorphins and enkephalins and mediate descending inhibition of pain-modulating pathways within the brain and dorsal horn of the spinal cord.
  • Useful agents for the treatment of mild to severe pain.
  • Opioids are usually classified as agonists, partial agonists or agonist-antagonists, and antagonists.
  • Three main opioid receptor types have been identified (mu, kappa and delta).
  • Moderate to severe pain is best treated with full agonist opioids that bind primarily to mu receptors: morphine Morphine, hydromorphone, oxymorphone, fentanyl Fentanyl and remifentanyl.
  • Partial agonists are best suited for conditions associated with mild to moderate pain or where extra sedation is needed.
  • Opioids can provide sedation Sedation in addition of their analgesic properties Analgesia.
  • Opioids can be combined with other drugs (NSAIDs Therapeutics: non-steroidal anti-inflammatory drugs, ketamine Ketamine, alpha-2 agonists, etc) for additive analgesic effects (multimodal analgesia).
  • Opioids are controlled substances.

Drugs

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Side effects

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Benato L, Rooney N J, Murrell J C (2019) Pain and analgesia in pet rabbits within the veterinary environment: a review. Vet Anaesth Analg 46 (2), 151-162 PubMed.
  • Rockwell K (2019) Buprenorphine. J Exotic Pet Med 30, 12-16.
  • Deflers H, Gandar F, Bolen G et al (2018) Influence of a single dose of buprenorphine on rabbit (Oryctolagus cuniculus) gastrointestinal motility. Vet Anaesth Analg 45 (4), 510-519 PubMed.
  • DiVicenti L Jr., Meirelles L A & Westcott R A (2016) Safety and clinical efffectiveness of a compounded sustained-release formulation of buprenorphine for postoperative analgesia in New Zealand White rabbits. JAVMA 248 (7), 795-801 PubMed.
  • Touzot-Jourde G, Nino V & Holopherne-Doran D (2015) Comparison of methadone and morphine sedation and analgesia in the NZW rabbit. J Vet Pharmacol Therap 38 (Suppl I), 70-71 ResearchGate.
  • Gusak V, Turkovic V, Nesek-Adam V et al (2013) Lidocaine serum concentration after epidural administration in combination with morphine and fentanyl in rabbit - a preliminary study. Res Vet Sci 94 (3), 651-655 PubMed.
  • Sakuraba S, Tsujita M, Arisaka H et al (2009) Donepezil reverses buprenorphine-induced central respiratory depression in anesthetized rabbits. Biol Res 42 (4), 469–475 PubMed.

Other sources of information

  • Plumb D (2015) Plumb’s Veterinary Drug Handbook. 8th edn. Wiley-Blackwell, UK. pp 1296.
  • Maguire S & Hawk C T (2012) Formulary. In: The Laboratory Rabbit, Guinea Pig, Hamster, and other Rodents. Eds: Suckow M, Stevens K & Wilson R. Academic Press, USA. pp 1193-1229.
  • Lester P A, Moore R M & Shuster K A (2012) Anesthesia and Analgesia. In: The Laboratory Rabbit, Guinea Pig, Hamster, and other Rodents. Eds: Suckow M, Stevens K & Wilson R. Academic Press, USA. pp 33-56.


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