New and emerging analgesics and analgesic technologies for acute pain management.
OBJECTIVE
Recent advances in drug delivery technology have provided new means of delivering medications with improved efficacy and safety. This review details developments in drug delivery recently made available or in development with the potential to better deliver analgesia.


RESULTS
Patient-controlled analgesia of intravenous medications was a major advance in drug delivery technology that allowed opioids to be administered more effectively and more safely. Extension of this technology to medications not administered intravenously has further broadened therapeutic options in the treatment of acute pain. Improvements in sustained-release formulations and patient-controlled analgesia modalities that are not catheter-based confer the potential to deliver analgesia less invasively. Receptor-specific antagonists allow opioids to be administered with fewer untoward side effects.


CONCLUSIONS
New routes of administration allow familiar medications to be utilized with greater clinical efficacy. Elimination of the need for indwelling catheters may reduce both the frequency of analgesic gaps and catheter-related complications. Physicians need to be familiar with developments in drug delivery technologies to be able to effectively utilize analgesics as part of well designed multimodal regimens to bring effective and well tolerated analgesia to patients with acute pain.
Heitz
James W
JW
Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA. james.heitz@jefferson.edu
Witkowski
Thomas A
TA
Viscusi
Eugene R
ER
D016058:Analgesia, Patient-Controlled / Q000295:instrumentation / Q000379:methods / Q000639:trends; D000700:Analgesics / Q000008:administration & dosage*; D002408:Catheters, Indwelling / Q000009:adverse effects; D003692:Delayed-Action Preparations; D016503:Drug Delivery Systems; D004867:Equipment Design; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007270:Injections, Intra-Articular; D007276:Injections, Intraventricular; D007478:Iontophoresis / Q000379:methods; D009020:Morphine / Q000008:administration & dosage*; D017409:Sufentanil / Q000008:administration & dosage
D000700:Analgesics; D003692:Delayed-Action Preparations; D009020:Morphine; D017409:Sufentanil; D005283:Fentanyl