[Opioids in anesthesia].
Opioids are the most effective and widely used drugs in the treatment of severe acute and chronic pain. They act through opioid receptors that belong to the family of G protein-coupled receptors. Three classes of opioid receptors (mu, delta, kappa), expressed in the central and peripheral nervous system, have been identified. The analgesic effect of opioids is mediated through multiple pathways of opioid receptor signaling (e.g., G(i/o) coupling, cAMP inhibition, Ca(++) channel inhibition). The standard exogenous opioid analgesics used in the operating room are fentanyl, sufentanil, morphine, alfentanil, and remifentanil. Preclinical pharmacology, clinical applications, and side effects will be reviewed in this chapter.
Zöllner
C
C
Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Deutschland. c.zoellner@uke.de
Schäfer
M
M
D000595:Amino Acid Sequence; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000758:Anesthesia; D000767:Anesthesia, Epidural; D000771:Anesthesia, Intravenous; D006801:Humans; D007278:Injections, Spinal; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D017450:Receptors, Opioid, mu / Q000187:drug effects / Q000235:genetics
D000701:Analgesics, Opioid; D017450:Receptors, Opioid, mu; D009020:Morphine