In vitro determination of human dura mater permeability to opioids and local anaesthetics Identification of specific opiate receptors in the brain and spinal cord and the subsequent demonstration that spinal (epidural and intrathecal) administration of opiates may lead to segmental spinal analgesia is the basis for epidural narcotic injection, i-3 Studies in animals and humans have demonstrated recently that pre-and postsynaptic receptors in the substantia gelatinosa of the dorsal horn of the spinal cord may be a major site of action of spinal opioids? The epidural route of administration offers several advantages over direct intrathecal (cerebrospinal fluid) administration, such as accessibility to all spinal segments and the possibility of repeated doses through an indwelling catheter. However, following epidural injection, there are at least three competing processes: transfer across the meninges, vascular uptake, and distribution into extradural adipose tissue. In order to gain access to the cerebrospinal fluid epidural opioids must first penetrate the dura mater. Clinical studies have demonstrated CAN J ANAESTH 1993 / 40: 2 / pp 165-9
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