Opioid agonists are frequently used to provide anesthesia in combination with sedatives and hypnotic agents and manage postoperative acute pain. There are many different opioid agents available that differ in their potency, onset and duration of action, metabolism, drug interactions, and side-effect profile. All opioids have distinct effects upon various organ systems, including central nervous system depression, respiratory depression, and decreased gastrointestinal motility. Fentanyl and fentanyl-derived agents (alfentanil, sufentanil, remifentanil) are most frequently used in the intraoperative period due to their quick onset and duration of action, allowing them to be easily titrated and discontinued at the completion of a procedure. Oral opioids with moderate durations of action, such as oxycodone, hydrocodone, and morphine, are commonly used for acute pain management in the postoperative setting. When oral analgesics cannot be used, intravenous patient-controlled analgesia is another option for pain management.
This review contains 5 figures, 11 tables, and 59 references.
Key Words: analgesia, anesthesia, central nervous system depression, fentanyl, morphine, opioid agonist, pain management, patient-controlled analgesia, perioperative, respiratory depression
PSY24 THE ECONOMIC CONSEQUENCES OF POST OPERATING PAIN MANAGEMENT WITHTRANSDERMAL FENTANYL (IONSYS) VERSUS INTRAVENOUS PATIENT-CONTROLLED ANALGESIA
