05a_08_11 Step III: Administration Techniques – Epidural, Intrathecal

Step III: Administration Techniques – Epidural, Intrathecal
Session Overview
Description
This session looks at the action of opioids given by epidural and intrathecal routes and considers the key adverse effects; it will enable you to execute a management strategy for these adverse effects.

Learning Objectives
By the end of this session you will be able to:

• Summarize the site of action of opioids given by epidural and intrathecal routes
• Explain how drug lipophilicity affects absorption, clinical effects and side-effects
• Recall dose ranges for three opioids given by epidural or intrathecal routes
• Summarize four adverse effects

Prerequisites
Before commencing this session you should:

• Module 05a/Pharmacology Treatments/Step II-III: Opioids - commonly available opioids (001-0512)
• Module 05a/Pharmacological targets/Central nervous system (001-0500)
• Module 05b/Neuraxial techniques/Performing spinal and epidural injections (001-0538)

This session covers the use of spinal opioids in acute pain.

Opioids delivered by the spinal route offer a powerful analgesic tool for thoracic, abdominal and lower limb surgery.

To use opioids effectively and safely in this way we need to understand how drug lipophilicity affects:

• Spread within the cerebrospinal fluid delivery to receptor sites
• Speed of onset
• Duration of action
• Side-effects