منابع مشابه
Opioid tolerance or opioid withdrawal?
To the Editor: We thank Kim et al. for their recent work examining the effect of intraoperative remifentanil on postoperative analgesia in children.1 Certainly, the pharmacokinetic profile of this potent opioid is attractive in modern anesthetic practice, and a thorough understanding of the principles behind tolerance, hyperalgesia, and withdrawal of remifentanil are critical for its safe admin...
متن کاملOpioid tolerance and hyperalgesia.
Opioids have been successfully used for the management of acute and cancer-related pain. Concerns regarding side effects, tolerance, dependence, addiction, and hyperalgesia have limited the use of opioids for the management of chronic nonmalignant pain. This article will review updated information from both clinical and preclinical studies regarding opioid-induced hyperalgesia, tolerance, and d...
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Lactate measurement in the critically ill has been traditionally used to stratify patients with poor outcome. However, plasma lactate levels are the result of a finely tuned interplay of factors that affect the balance between its production and its clearance. When the oxygen supply does not match its consumption, organisms such as man who are forced to produce ATP for their integrity adapt in ...
متن کاملCritiCal illness in pregnanCy
Critical illness in pregnancy increases maternal and fetal morbidity and mortality. The critical illness can be related to pregnancy per se, or can be secondary to a concurrent medical illness. Early identification and appropriate management results in good outcomes with a short ICU stay. Late identification and delayed therapy results in poor maternal & fetal outcomes with development of multi...
متن کاملOpioid tolerance: the clinical perspective.
Uncertainty about the clinical significance of tolerance to opioid analgesia has important and diverse implications. Although understanding of the characteristics and mechanisms of experimental tolerance has grown, the clinical correlates and ramifications of these findings remain ambiguous to practitioners prescribing long-term opioid therapy to patients for the treatment of malignant and non-...
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ژورنال
عنوان ژورنال: New England Journal of Medicine
سال: 2019
ISSN: 0028-4793,1533-4406
DOI: 10.1056/nejmra1800222