Articles: hyperalgesia.
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Despite being the mainstay of pain management, opioids are limited in their clinical utility by adverse effects, such as tolerance and paradoxical hyperalgesia. Research of the past 15 years has extended beyond neurons, to implicate central nervous system immune signaling in these adverse effects. This article will provide an overview of these central immune mechanisms in opioid tolerance and paradoxical hyperalgesia, including those mediated by Toll-like receptor 4, purinergic, ceramide, and chemokine signaling. Challenges for the future, as well as new lines of investigation will be highlighted.
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Int J Clin Pharm Th · Apr 2015
Effects of pregabalin on central sensitization in patients with migraine.
Despite the fact that the most recently articulated theory of migraine is the central sensitization hypothesis, few basic and clinical research studies on central sensitization have been conducted in patients with migraine. Here, we aim to reveal the risk factors of migraine with allodynia and to illustrate the effects of pregabalin on alleviating allodynia. ⋯ Our results showed that 65.1% of patients with migraine had allodynia and that migraine with allodynia was related to the patient gender (female), disease duration, and medication overuse. Pregabalin was effective at relieving allodynia in migraine.
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Randomized Controlled Trial
A randomized, double-blind, crossover study to evaluate the depth response relationship of intradermal capsaicin-induced pain and hyperalgesia in healthy adult volunteers.
The purpose of this study was to evaluate pain and hyperalgesia in response to different depths of intradermal (ID) capsaicin injections in healthy volunteers. ⋯ Injection of capsaicin at different depths in the skin had different effects on heart rate and blood pressure but no effect on pain. These results may have implications on the pharmacology and analgesic predictive value of the model of ID capsaicin.
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Observational Study
Hyperalgesia induced by low-dose opioid treatment before orthopaedic surgery: An observational case-control study.
Chronic pain and opioid consumption may trigger diffuse hyperalgesia, but their relative contributions to pain vulnerability remain unclear. ⋯ Chronic pain patients treated with low doses of opioid had hyperalgesia before surgery. These results highlight the need to personalise the management of patients treated with opioids before surgery.