Editorial Views  |   November 2016
Potent Opioid Analgesia without Respiratory Depression: Could It Be Possible?
Author Notes
  • Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.
  • Corresponding article on page 1017.
    Corresponding article on page 1017.×
  • Accepted for publication June 20, 2016.
    Accepted for publication June 20, 2016.×
  • Address correspondence to Dr. Dahan: a.dahan@lumc.nl
Article Information
Editorial Views / Central and Peripheral Nervous Systems / Pain Medicine / Respiratory System
Editorial Views   |   November 2016
Potent Opioid Analgesia without Respiratory Depression: Could It Be Possible?
Anesthesiology 11 2016, Vol.125, 841-843. doi:10.1097/ALN.0000000000001321
Anesthesiology 11 2016, Vol.125, 841-843. doi:10.1097/ALN.0000000000001321
THE first known written reference to the medicinal use of the opium poppy dates from 4,000 BC in Sumerian clay tablets.1  We have come a long way since the use of opium sap, but despite its many disadvantages, we still abundantly use drugs that activate the endogenous opioid system. These drugs are identical (e.g., morphine) or very much alike the many active alkaloids that are present in opium sap. In fact, in contemporary medicine, opioid analgesics remain the most potent painkillers that we have and consequently that we use in the pharmacologic treatment of acute (perioperative) and chronic pain. However, the use of opioids comes at the price of serious adverse effects, including potentially life-threatening respiratory depression and the potential for abuse and addiction. Inadvertent overdosing resulting in unintentional mortality from prescription opioids for the treatment of chronic pain has increased dramatically over the last decades.2,3  This is partly attributed to an increased awareness by clinicians to diagnose and treat chronic pain and pressure from the industry to treat moderate to severe pain with opioids.2 
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