Factors determining plasma leel of an epidural opiate

Total dose Increases plasma leels and side effects Lipid solubility Increasing lipid solubility increases vascular uptake rather than rostral spread, eg. fentanyl/pethidine versus morphine. CSF (rather than plasma) concentration parallels analgesia. Opiate receptor affinity High for lofentanil & sufentanil (les vascular absorption; shorter duration of action)