Peripherally acting mu-opioid-receptor antagonists and the connection between @entity86 and XXXX management: The anesthesiologist's view and beyond.

@entity1 @entity1337 @entity86 @entity158 @entity3840 @entity29141
The adverse effects of opioids are well documented. Because opioid receptors have a wide-ranging anatomic distribution, the effects subsequent to opioid binding, both good and bad, occur centrally and in the periphery. Postoperative strategies to reduce opioid burden, therefore, are in the @entity1 's best interest. Multimodal @entity1337 is the key towards balancing the need for opioids while simultaneously reducing their burden. Alternative anesthesia and @entity1337 options such as regional anesthesia, nonsteroidal anti-inflammatory drugs, or @entity3840 enzyme inhibitors should be considered part of multimodal protocols. Familiarity of where these drugs are active in the body and how they can be employed is imperative for all surgical team members. Optimal implementation of multimodal approaches can reduce hospital stay and improve clinical outcomes, including @entity1 satisfaction. Finally, strategies that may help reduce rates of hospital readmission also contribute to overall improved outcome. New peripherally acting mu-opioid-receptor antagonists represent significant progress in the ability of perianesthesia nurses to play an even greater role in achieving these goals. In contrast to older opioid-receptor antagonists, these agents specifically target an important aspect of the multifactorial etiology of @entity86 ( @entity86 ), mu-opioid-receptor-mediated activity in the GI tract. In addition, they do not pass the blood-brain barrier or diminish opioid-mediated @entity1337 . Advanced clinical trials have already demonstrated the ability of one of these agents, @entity29141 , to reduce @entity86 and improve other postoperative outcomes while maintaining adequate @entity1337 . Combined with other options aimed at reducing opioid burden, alvimopan and similar drugs in development hold promise as part of multimodal protocols to optimize @entity158 management while minimizing postoperative morbidities.
