Search results for "Opioid-induced hyperalgesia"
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The Endogenous Opioid System Is Not Involved in Modulation of Opioid-Induced Hyperalgesia
2009
Abstract Some recent studies suggested a role of the endogenous opioid system in modulating opioid-induced hyperalgesia (OIH). In order to test this hypothesis, we conducted a prospective randomized, placebo-controlled, 2-way crossover study in healthy human volunteers. We utilized a well-established model of inducing OIH after a brief exposure to the μ-opioid agonist remifentanil using intradermal electrical stimulation. Patients were exposed to a randomized 90-minute infusion of remifentanil or saline placebo during 2 separate occasions. Development of OIH was quantified using changes in the average radius of the area of secondary hyperalgesia generated by electrical pain stimulation. A 2…
Opioid-induced hyperalgesia after rapid titration with intravenous morphine: Switching and re-titration to intravenous methadone.
2012
Rapid titration with intravenous morphine (IV-MO) provides fast and efficient pain relief in cancer patients with severe-excruciating pain. However, some patients, after an initially favourable response, can develop an hyperexcitated state unrelieved or worsened by further dose increments.Eighty-one patients admitted on emergency basis titrated with IV-MO were assessed.12 patients were unsuccessfully titrated with IV-MO. Switching to intravenous methadone (IV-ME) and titrating the doses proved to be successfully.In escalating opioid doses rapidly a recognition of the development of hyperalgesia should be suspected. Increasing doses of opioids may stimulate rather than inhibiting the central…