Historical Journey of Spinal Opioids for Postoperative Pain.

What is it about?

Opioids have been considered by clinical physicians the strongest option in clinical practice for the treatment of postoperative pain. Humans have been administering opioids for many years in an effort to produce either analgesia or other clinical and recreational effects mediated by the central nervous system. Spinal opioids have become a current and extended practice for the treatment of acute postoperative pain, obstetric analgesia and also cancer-related pain due to its great effectiveness. However, the spinal administration of an opioid drug does not always guarantee segmental analgesia and also selective action in the spine. Evidence from experimental studies indicates that the bioavailability in the spinal cord biophase correlates negatively with liposolubility. This one is higher for hydrophilic opioids, such as morphine than lipophilic opioids, such as fentanyl, sufentanil, ​and alfentanil. In this review from Ovid/Medline until June 2015, a historical journey from the past to current clinical guidelines on spinal opioids has been made

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