Ketamine Improves the Management of Exaggerated Postoperative Pain Observed in Perioperative Fentanyl-treated Rats

Richebé, Philippe; Rivat, Cyril; Laulin, Jean‐Paul; Maurette, P.; Simonnet, Guy

doi:10.1097/00000542-200502000-00028

Cited by 120 publications

(89 citation statements)

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“…Sevoflurane exposure at 1.0% for 4.5 h on D 0 prevented the development of hyperalgesia. This protective effect of sevoflurane could be analogous to that observed with NMDA antagonists (e.g., MK-801, ketamine) in rats 7,8,33 and in humans. 9 Moreover, several in vitro electrophysiological and pharmacological studies have demonstrated sevoflurane's anti-NMDA properties.…”

Section: Discussionsupporting

confidence: 58%

“…On the following three days, the NT values were diminished compared to the basal value (Dunnett's tests, P \ 0.001 on D 1 , P \ 0.001 on D 2 , and P = 0.002 on D 3 ). When the NT returned to the basal value, naloxone administration on D 7 , induced a significant decrease in the NT compared to basal value (Student's t test, P = 0.0013) and saline rats (Dunnett's test, P = 0.003).…”

Section: Resultsmentioning

confidence: 88%

“…After two-way ANOVAs were completed for comparison between groups, post-hoc Dunnett's tests were administered to test for comparison between groups. Paired Student's t tests were used to compare the hyperalgesic effect induced by naloxone on D 7 . The accepted value for significance was P \ 0.05.…”

Section: Discussionmentioning

confidence: 99%

“…7,20 When sevoflurane was discontinued, the rats quickly awoke and NT values decreased within 30 to 60 min to respective basal values. The nociceptive thresholds remained stable for several days until D 7 .…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Enhanced hyperalgesia was observed for several days after injections of high doses of fentanyl were administered to animals that were subjected to inflammatory or surgical pain in response to nociceptive inputs. 7,8 In human volunteers, other opioids, such as remifentanil, induced not only analgesia but also hyperlagesia once the medication was discontinued. 9 Although opioids remain an essential component of acute postoperative pain management, anesthesiologists should take into account the potential for these drugs to exacerbate post-operative pain when high doses are administered to patients intraoperatively.…”

Section: Résumémentioning

confidence: 99%

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Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Richebé

Rivalan

Rivat

et al. 2008

Can J Anesth/J Can Anesth

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Purpose Opioids are widely used for anesthesia but paradoxically induce postoperative pain hypersensitivity via N-methyl-D-aspartate (NMDA) receptor modulation. Sevoflurane effects on opioid-induced hyperalgesia have not been yet evaluated in vivo. Nevertheless, some experimental in vitro studies reported anti-NMDA receptor properties for sevoflurane. The aim of this study was to evaluate sevoflurane effects on fentanyl-induced hyperalgesia in opioid-naive rats and in rats with inflammatory pain. Methods Sevoflurane effects on hyperalgesia were evaluated in Sprague-Dawley rats: opioid-naive rats, rats treated with fentanyl (4 9 60 lg kg -1 ) and rats with inflammatory pain (carrageenan) treated with fentanyl (4 9 60 lg kg -1 ). On day zero, subcutaneous fentanyl injections were administered and inflammatory pain was induced with one carrageenan injection in one hind paw. Rats were exposed to low concentrations of sevoflurane (1.0 or 1.5%) on day zero prior to fentanyl injections and inflammatory pain induction, and for the duration of the fentanyl analgesic effect. The nociceptive threshold (Randall-Selitto test) was evaluated daily for 7 days. On day seven, naloxone was injected and the nociceptive threshold was assessed 5 min later. Results In rats without inflammatory pain but treated with fentanyl on day zero, sevoflurane 1.0% reversed the early (day zero) and long-lasting (day zero to day three) hyperalgesia classically described after high-doses of fentanyl (P \ 0.05). This sevoflurane concentration antagonized the hyperalgesia induced by naloxone on day seven (P = 0.33). In a second experiment in rats with inflammatory pain, exposure to low concentrations of sevoflurane (1.0 and 1.5%) did not reduce fentanyl-induced hyperalgesia (P [ 0.05), but nevertheless antagonized the naloxone induced hyperalgesia on day seven (P = 0.061). Conclusion Relatively low sevoflurane concentrations (1.0%) reverse fentanyl-induced hyperalgesia in rats without inflammatory pain. Nevertheless, the lack of effect of sevoflurane concentrations of 1.0% and 1.5% to oppose hyperalgesia following high-dose fentanyl and inflammatory pain suggests that sevoflurane anti-hyperalgesic properties are weak. RésuméObjectif Les opioı¨des sont largement utilise´s en anesthe´sie mais induisent paradoxalement une hypersensibiliteṕ ostope´ratoire a`la douleur via une modulation des re´cepteurs N-me´thyl-D-aspartate (NMDA). Les effets du

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Section: Discussionsupporting

confidence: 58%

Section: Resultsmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

See 3 more Smart Citations

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Richebé

Rivalan

Rivat

et al. 2008

Can J Anesth/J Can Anesth

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Latent Sensitization: A Model for Stress‐Sensitive Chronic Pain

et al. 2015

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Latent sensitization is a rodent model of chronic pain that reproduces both its episodic nature and its sensitivity to stress. It is triggered by a wide variety of injuries ranging from injection of inflammatory agents to nerve damage. It follows a characteristic time course in which a hyperalgesic phase is followed by a phase of remission. The hyperalgesic phase lasts between a few days to several months, depending of the triggering injury. Injection of μ-opioid receptor inverse agonists (i.e., naloxone, naltrexone) during the remission phase induces reinstatement of hyperalgesia. This indicates that the remission phase does not represent a return to the normal state, but rather an altered state in which hyperalgesia is masked by constitutive activity of opioid receptors. Importantly, stress also triggers reinstatement. Here we describe in detail the procedures to induce and follow latent sensitization in its different phases in rats and mice.

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Synergism between oral paracetamol and nefopam in a murine model of postoperative pain

Cabañero

2021

European Journal of Pain

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Ketamine Improves the Management of Exaggerated Postoperative Pain Observed in Perioperative Fentanyl-treated Rats

Abstract: By opposing postoperative pain hypersensitivity and subsequent short-term tolerance induced by perioperative opioid use, ketamine not only improves exaggerated postoperative pain management but also provides better postoperative rehabilitation.

Cited by 120 publications

References 33 publications

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Effects of sevoflurane on carrageenan- and fentanyl-induced pain hypersensitivity in Sprague-Dawley rats

Latent Sensitization: A Model for Stress‐Sensitive Chronic Pain

Synergism between oral paracetamol and nefopam in a murine model of postoperative pain

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