Opioids: maximizing efficacy, minimizing adverse effects

摘要

The use of opioids in efforts to achieve pain relief for chronic noncancer pain has remained among the most controversial issues in medicine throughout the ages. Opioids are potent broad-spectrum analgesics that may provide significant analgesia to patients with severe chronic pain, but also possess qualities that make them prone to misuse in certain subpopulations of patients. Examinations of opioid therapy seem to repeatedly focus on their role as analgesics; however, in palliative medicine they may also be used as cough suppressants, sedatives or to ameliorate the uncomfortable sensation of dyspnea.One of the earliest known written references to the medicinal use of opioids was found in the Eber Papyrus of 1552 BCE, which has been translated as: