Zusammenfassung
Vor über 180 Jahren gelang es Sertürner, reines Morphin aus Opium zu gewinnen; vor über 60 Jahren wurde die chemische Struktur des Morphins analysiert. Wie bereits dargestellt, steht heute eine breite Palette von Opioiden zur Verfügung, Opioidrezeptoren sind im Gehirn und Rückenmark lokalisiert worden, und ganze Wälder mußten gefällt werden, um das Papier zu liefern, das für die Veröffentlichungen zur Analytik und Pharmakokinetik der verschiedenen Opioide erforderlich war. Man sollte deshalb annehmen können, daß wir in der Lage sind, jedem Patienten eine billige, sichere und effektive Analgesiemethode anbieten zu können. Dies ist jedoch leider nicht der Fall [40]. Die postoperative Schmerzbehandlung der meisten Patienten ist ineffektiv [26, 29, 38, 41]. Es stellt sich daher die Frage, warum so viele Patienten in so vielen Krankenhäusern weiterhin unter postoperativen Schmerzen zu leiden haben. Nach allem, was wir wissen, müßte es doch recht einfach sein, das richtige Medikament und den richtigen Zugangsweg auszuwählen, die richtige Dosis zur richtigen Zeit zu geben, um genügend Opioid an die entscheidenden Wirkorte zu bringen, und dann eine Strategie anzuwenden, um die Konzentration dort für eine angemessene Zeit hoch genug zu halten.
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Runciman, W.B., Mather, L.E., Owen, H. (1994). Opioidagonisten: Anwendung und Dosierung. In: Lehmann, K.A. (eds) Der postoperative Schmerz. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-21762-7_13
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