REVISTA

Encuesta a especialistas del dolor sobre la relación de las dosis analgésica de opioides usadas IV, EP o IT

Descripción: La relación 100 IV (intravenosa): 10 EP (epidural): 1 IT (intratecal) fue la respuesta más común de los encuestados, especialmente para la morfina, aunque también para la hidromorfona y el fentanilo

TITULO FUENTE ORIGINAL:

Survey of pain specialists regarding conversion of high-dose intravenous to neuraxial opioids

AUTORES:

Gorlin AW, Rosenfeld DM, Maloney J, Wie CS, McGarvey J, Trentman TL

REVISTA ABREV.:

J Pain Res

AÑO:

2016

REFERENCIA:

9:693-700

DOI:

10.2147/JPR.S113216

RESUMEN ORIGINAL:

The conversion of high-dose intravenous (IV) opioids to an equianalgesic epidural (EP) or intrathecal (IT) dose is a common clinical dilemma for which there is little evidence to guide practice. Expert opinion varies, though a 100 IV:10:EP:1 IT conversion ratio is commonly cited in the literature, especially for morphine. In this study, the authors surveyed 724 pain specialists to elucidate... + Leer más

The conversion of high-dose intravenous (IV) opioids to an equianalgesic epidural (EP) or intrathecal (IT) dose is a common clinical dilemma for which there is little evidence to guide practice. Expert opinion varies, though a 100 IV:10:EP:1 IT conversion ratio is commonly cited in the literature, especially for morphine. In this study, the authors surveyed 724 pain specialists to elucidate the ratios that respondents apply to convert high-dose IV morphine, hydromorphone, and fentanyl to both EP and IT routes. Eighty-three respondents completed the survey. Conversion ratios were calculated and entered into graphical scatter plots. The data suggest that there is wide variation in how pain specialists convert high-dose IV opioids to EP and IT routes. The 100 IV:10 EP:1 IT ratio was the most common answer of survey respondent, especially for morphine, though also for hydromorphone and fentanyl. Furthermore, more respondents applied a more aggressive conversion strategy for hydromorphone and fentanyl, likely reflecting less spinal selectivity of those opioids compared with morphine. The authors conclude that there is little consensus on this issue and suggest that in the absence of better data, a conservative approach to opioid conversion between IV and neuraxial routes is warranted

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ENLACES DE INTERÉS

Enlace al pdf de acceso libre: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC[...]