Postoperative epidural opioid analgesia analysis.docVIP

 PAGE \* MERGEFORMAT 13 Postoperative epidural opioid analgesia analysis [Abstract] recent epidural opioid analgesia were reviewed literature shows that: continuous infusion of hydrophilic opioids can produce selective spinal analgesia, low incidence of side effects, lipophilic opioid analgesic drugs production may be related to the role of spinal cord, but separate epidural analgesia compared with intravenous administration of no obvious advantage, combined with small doses of fat-soluble opioid and local anesthetic injection alone compared with systemic opioids may have significant clinical advantages, but also further research is needed to obtain analgesic dose range of the best, the lowest incidence of clinical adverse effects. [Keywords:] postoperative epidural opioid analgesia 1979 Beharo [1] into the epidural morphine for intractable pain has been successful, people epidural opioid analgesia for a lot of research. Epidural opioids alone or with a local anesthetic Ng Not only can produce effective analgesia, but also reduce the perioperative incidence of physiological disorders and improve the comprehensive quality of patients. An epidural opioid mechanism of action 1.1 epidural analgesic mechanism of opioids Peripheral noxious C fiber conduction signal to the spinal cord through the posterior horn, prompting the release of presynaptic neuropeptide levels (P substance and neurokinin A) and excitatory amino acids. Postsynaptic neurokinin and neurokinin receptor NK1, NK2 binding , by activating GTP protein produced changes in depolarization and second messengers. glutamate can act on the dorsal horn neurons postsynaptic @ - amino -3-- hydroxyl -5-- methyl -4-- isoxazole propionic acid (AMPA) and N-methyl-D-aspartate (NMDA) receptors. connected with the NMDA receptor ion channel is usually blocked by magnesium ions. However, the cells to make the magnesium ion polarization removed, causing calcium ions, sodium ions flow, leading to f