Opioids during and after surgery

Small doses of opioids given with induction can usefully reduce the dose requirements of drugs used during anaesthesia. Those used are:

Fentanyl (t1/, 3 h) has higher efficacy than morphine, analgesia lasts 30-60 min (single dose) and is used i.v. Fentanyl is also given for chronic and intractable cancer pain as self-adhesive patches which release the drug at approximately 25 micrograms /h for 72 h. Fentanyl is so potent that discarded patches may yet contain sufficient drug to be dangerous.

Alfenatil (t1/ 1.5 h), given i.v., provides maximum analgesia in 90 seconds, which lasts about 5-10 min from a single dose; it is used for brief (painful) operations.

Remifentanil is rapidly metabolised, not in the liver but by blood and tissue esterases. Its short duration of action renders it well suited for continuous i.v. infusion without accumulation.

Opioids (nonanalgesic) for an antimotility effect on the gut include loperamide and diphenoxylate (p. 644).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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