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by E.K. ZSIGMOND, M.D. Department of Anesthesiology University of Illinois Chicago U.S.A. It is, indeed, a distinct honor and privilege to be invited by the authors to write a preface to this monumental monograph, Regional Opioid Analgesia. Regional Opioid Analgesia is a colossal undertaking by Drs. De Castro, Meynadier and Zenz shortly after the introduction of this revolutionary approach to pain relief which opened a new epoch in analgesiology. This is, indeed, the first authentic and comprehensive textbook encompassing the current knowl edge on this novel approach to pain relief. We are indebted to the authors for introducing the new opioids to regional analgesia with the scientists, who de veloped the potent short and ultrashort acting opioids with high therapeutic indices, which many researchers dreamt about but never before materialized. The side effect liabilities of these new opioids are minute as compared to morphine and meperidine. Regional Opioid Analgesia could not have been more authentically written than by Drs. De Castro,Zenz and Meynadier,who have conducted daily clinical investigations on all known opioids for regional analgesia as well as for neurolept analgesia. Therein lies the great value of this monograph: it is the most authentic work on this topic.
I: Anatomical, Pharmacological, Physiological and Technical Basis of Spinal Regional Opioid Administration.- 1. Developments, advantages and drawbacks of regional opioid analgesia.- 2. Anatomy and physiology.- 3. Micropharmacology of antinociceptive substances in the spinal cord.- 4. Pharmacokinetics of opioids.- 5. Pharmacodynamics of opioids.- 6. Side effects.- 7. Drugs.- 8. Equipment and drug delivery systems.- II: Clinical Practice of Spinal Opioid Administration.- 9. Clinical applications, generalities.- 10. Intraoperative use.- 11. Postoperative pain.- 12. Other applications in acute pain situations.- 13. Obstetrics.- 14. Cancer pain.- 15. Chronic non-malignant pain.- 16. Perineural opioid analgesia (PNOA).- 17. Comparative evaluation of the risk/benefit ratio.- 18. Future directions in spinal opioid research and conclusions.- 19. What is regional opioid analgesia?.- 20. Technical data of equipment for spinal opioid therapy.- Bibliography and references.- Addendum to the Bibliography and references.- Index of subjects.
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