Editorial Views  |   May 2018
μ-Opioid Receptor Agonists: Do They Have Utility in the Treatment of Acute Pain?
Author Notes
  • From the Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado (T.K.H.); the Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, Colorado (T.K.H.); the Department of Psychiatry, Division of Substance Dependence, University of Colorado School of Medicine, Aurora, Colorado (S.K.M.-G.); and the Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado (S.K.M.-G.).
  • Corresponding article on page 932.
    Corresponding article on page 932.×
  • This is a 2017 Frontiers in Opioid Pharmacotherapy Symposium article.
    This is a 2017 Frontiers in Opioid Pharmacotherapy Symposium article.×
  • Accepted for publication February 5, 2018.
    Accepted for publication February 5, 2018.×
  • Address correspondence to Dr. Henthorn: thomas.henthorn@ucdenver.edu
Article Information
Editorial Views / Pain Medicine / Pharmacology / Opioid
Editorial Views   |   May 2018
μ-Opioid Receptor Agonists: Do They Have Utility in the Treatment of Acute Pain?
Anesthesiology 5 2018, Vol.128, 867-870. doi:10.1097/ALN.0000000000002177
Anesthesiology 5 2018, Vol.128, 867-870. doi:10.1097/ALN.0000000000002177
IN this issue of A nesthesiology, Roozekrans et al.1  have revisited the utility function to emphasize the balance between therapeutic efficacy and toxicity of opioids. They reanalyze data from three previously published studies of the analgesic and respiratory depressant effects of alfentanil2–4  to determine “utility” from the perspective of producing analgesia without significant respiratory depression. Further exploration of the theoretical underpinnings of opioid utility is particularly a propos given the escalating number of respiratory depression deaths due to the opioid epidemic5,6  coupled with the most salient finding of the pharmacokinetic–pharmacodynamic analysis of Roozekrans et al.1 : that the EC50 for alfentanil analgesia exceeds the EC50 for respiratory depression. This is far from an encouraging therapeutic index. It is, therefore, worth comparing this new work with prior operationalizations of opioid utility while reflecting on how the utility function can evolve and become a more central concept to clinicians, pharmacologists, and public health officials.
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