Opioid-induced hyperalgesia (OIH).

Abstract

BACKGROUND AND OBJECTIVES:

Opioids are commonly used for pain control; however, they can cause hyperalgesia. The reason why this can happen is not known. The objective of this review was to describe the mechanisms, factors implicated, and drug modulation.

CONTENTS:

The factors implicated in the development of opioid-induced hyperalgesia (OIH), such as duration of use, dose, and type of opioids are described. Mechanisms involved include the glutamatergic system and N-methyl-D-aspartate receptors (NMDA), spinal cyclooxygenase (COX) activation, excitatory amino acids, dynorphin, cytokines and chemokines; prostaglandins, and descending facilitation. Modulation of hyperalgesia could be done through: NMDA receptor antagonists, alpha2-adrenergic agonists, and COX inhibitors.

CONCLUSIONS:

This is a very complex subject, which involves a series of pathophysiological mechanisms that could contribute for OIH and patient discomfort, bringing disastrous consequences.

• Authors: Plínio da Cunha Leal, Jefferson Clivatti, João Batista Santos Garcia, Rioko Kimiko Sakata
• Journal: Revista brasileira de anestesiologia (Rev Bras Anestesiol) 2010 Nov-Dec Vol. 60 Issue 6 Pg. 639-47, 355-9 ISSN: 1806-907X [Electronic] Brazil
• PMID: 21146061 (Publication Type: Journal Article, Review)
• Copyright: © 2010 Elsevier Editora Ltda. All rights reserved.

Chemical References

• Analgesics, Opioid

Topics

• Analgesics, Opioid (adverse effects)
• Humans
• Hyperalgesia (chemically induced)