Review article

Alternative approaches to the application of opioids

Ivan Radoš ; Department of Anesthesiology and Intensive Care, Pain Units, University Hospital Osijek, Osijek, Croatia
Hrvoje Cernohorski ; Department of Anesthesiology and Intensive Care, Pain Units, University Hospital Osijek, Osijek, Croatia
Marica Kristić ; Department of Anesthesiology and Intensive Care, Pain Units, University Hospital Osijek, Osijek, Croatia
Gorana Fingler ; Department of Anesthesiology and Intensive Care, Pain Units, University Hospital Osijek, Osijek, Croatia

Abstract

Successful pain management with opioids requires that adequate analgesia be achieved without excessive adverse effects. The oral application of opioids is preferred as the easiest and most economic use, but there are potential side effects as nausea, disphagia, malabsorbtion, confusion and cognitive disorders, as well as unsatisfactory abatement of pain is spite of high dosage. When oral administration is not applicable, alternative routes are recommended. 53–70% of patients with carcinoma require an alternative route of opioid dministration. 50% of carcinoma patients need to alternate between the administration routes more than once during the last four weeks of their lives. Alternative routes of opioid administration include: transmucosal and sublingual, intranasal, transdermal, subcutaneous and intravenous, intramuscular, rectal, tube for feeding and intrathecal and epidural route. The onset of the effect of oral transmucosal and sublingual opioids is 15 to 30 minutes, intranasal opioids 2-3 minutes, intravenous opioids 15-30 seconds, and inhalation opioids 6-12 seconds. The ideal drug for pervasive carcinoma pain should be efficient, with a quick onset, short acting, only few side effects and uncomplicated application.

Keywords

administration of opioids; pain management; fentanyl

Hrčak ID:

278794

URI

https://hrcak.srce.hr/278794

Publication date:

30.11.2009.

Article data in other languages: croatian

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