traditional opioids."
Among those in devel-
opment, says Dr.
Viscusi, a professor of
anesthesiology and the
director of acute pain
management at
Thomas Jefferson
University in
Philadelphia, Pa., is a
"biased opioid ligand"
that could effectively
act on the same pain
receptors as morphine
and fentanyl without
promoting constipa-
tion, respiratory
depression or anal-
gesic tolerance.
Elsewhere, a kappa
opioid agonist, also in
development, may be
able to activate periph-
eral opioid receptors present on sensory nerves, but largely excluded
from the brain. That in turn could provide pain relief without significant
central nervous system side effects. If approved, it "should have no opi-
oid respiratory depression and may be a better analgesic for visceral
pain," says Dr. Viscusi.
Also piquing Dr. Viscusi's interest: a fixed-dose, long-acting combina-
tion of bupivacaine and the anti-inflammatory meloxicam. The tandem
6 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6
• BUILDING BLOCKS Regional anesthesia — with dramatically better
visualization — is expected to be the wave of the future.
