Systemic and Local Distribution of Opioids After Spinal Administration: Implications for their Clinical Use

  • Lars L. Gustafsson
Part of the Current Management of Pain book series (CUMP, volume 6)


Spinal opioid analgesia may be achieved either by epidural or intrathecal administration. The analgesic effect is exerted through the binding of drugs to opioid receptors in the dorsal horn of the spinal cord [1, 2]. The fraction of the dose that reaches the intended site of action in the spinal cord is lower with epidural than with intrathecal administration because of the high blood flow and pronounced distribution into the systemic circulation in the first case. Similar therapeutic and toxic effects can be present irrespective of the route of administration when equipotent doses are given.


Intrathecal Administration Epidural Morphine Intrathecal Morphine Epidural Administration Epidural Route 
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© Kluwer Academic Publishers 1990

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  • Lars L. Gustafsson

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