Spinal agents for acute pain management

Abstract

This article describes the current and investigational agents for use in the treatment of acute pain. The use of spinal and epidural routes also are discussed.

The evolving role of spinal agents in acute pain

“…Despite the fact that ketamine, an NMDA receptor antagonist, provides profound analgesia when administered intravenously, the efficacy of IT ketamine as a sole agent has been disappointing. Moreover, customary spinal doses of 25 to 80 mg have been associated with pyschometric side effects [34]. IT ketamine potentiates the effect and prolongs the duration of IT morphine, but provides neither benefit in combination with IT fentanyl in animal models [35].…”