Articles: hyperalgesia.
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Review Meta Analysis
Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis.
Intra-operative use of remifentanil may have a dose-response effect on inducing hyperalgesia and consequentially increasing post-operative pain.
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Expert Opin Drug Saf · May 2014
Review Meta AnalysisAn evidence based systematic review of remifentanil associated opioid-induced hyperalgesia.
Therapeutic opioid use continues to grow, with greater than a fivefold increase in usage of fentanyl-based products over a 10-year period. Opioids are known for their side-effect profile, including bradycardia and respiratory depression; questions remain, however, regarding lesser known side effects such as opioid-induced hyperalgesia (OIH). ⋯ There is conflicting evidence regarding the existence of remifentanil OIH. Outcomes evaluating measures of hyperalgesia frequently conclude that remifentanil OIH exists, while those evaluating opioid consumption do not. Therefore, remifentanil does induce a degree of hyperalgesia, but we do not believe that it reaches a level of clinical significance that requires prevention. If a significant concern for the development of remifentanil OIH is suspected, we suggest using the least possible effective dose of remifentanil as the primary prevention strategy.
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Review Meta Analysis
Do opioids induce hyperalgesia in humans? An evidence-based structured review.
DESIGN/OBJECTIVES: Consistent rodent evidence indicates that opioid exposure will decrease the rodent's pain threshold (ptr). This is termed opioids-induced hyperalgesia (OIH). Currently, the consistency of the evidence for the occurrence of OIH in humans is unclear. This is a structured evidence-based review for all levels of evidence (all studies and case reports) on OIH in humans in order to determine the consistency of this evidence. ⋯ There is not sufficient evidence to support or refute the existence of OIH in humans except in the case of normal volunteers receiving opioid infusions. Prospective CPP clinical studies measuring ptrs and tolerances pre- and post-opioid placement with CPP non-opioid control groups are required.