Opioid-induced Hyperalgesia

Abstract

Opioids are the cornerstone therapy for the treatment of moderate to severe pain. Although common concerns regarding the use of opioids include the potential for detrimental side effects, physical dependence, and addiction, accumulating evidence suggests that opioids may yet cause another problem, often referred to as opioid-induced hyperalgesia. Somewhat paradoxically, opioid therapy aiming at alleviating pain may render patients more sensitive to pain and potentially may aggravate their preexisting pain. This review provides a comprehensive summary of basic and clinical research concerning opioid-induced hyperalgesia, suggests a framework for organizing pertinent information, delineates the status quo of our knowledge, identifies potential clinical implications, and discusses future research directions.

Remifentanil-Induced Tolerance, Withdrawal or Hyperalgesia in Infants: A Randomized Controlled Trial. RAPIP Trial: Remifentanil-Based Analgesia and Sedation of Paediatric Intensive Care Patients

“…Most evidence for OIH derives from animal studies or studies in healthy volunteers, while investigations in clinical settings revealed varying results [21,22]. As short-acting opioids are particularly suspected to be associated with OIH, there are a number of studies demonstrating states of hyperalgesia following remifentanil exposure [23].…”

Hyperalgesia syndrome in animals and methods of its treatment according to experimental data and morphometry

“…-неможливість або обмеження використання ефективних сучасних методів післяопераційної анал-гезії та переконання частини лікарів, що такі діти є менш чутливими до болю [4].…”

“…Карагеніновий набряк відтво-рювали сублантарним введенням 0,05 мл 1 % розчи-ну карагеніну (Sigma, USA) в праву задню кінцівку тварини [4]. Спостереження за розвитком простаг-ландинового набряку у тварин обох статей прово-дили на 3-й годині (піку розвитку) після введення флогогену.…”

Opioid-induced Hyperalgesia: An Entity not so Common, but exists

“…It has also been observed with long-term use of hydrocodone, oxycodone as well as methadone. [2][3][4] We diagnosed OIH in our patient, who was implanted a morphine intrathecal pump to control her pain due to adenocarcinoma rectum, chemotherapy, and radiotherapy. She developed hyperalgesia after a span of 1 year as seen on dose escalation on refilling the pump during regular follow-ups.…”