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. ©Elsevier Editora Ltda.
CITATION STYLE
Da Cunha Leal, P., Clivatti, J., Garcia, J. B. S., & Sakata, R. K. (2010). Opioid-Induced Hyperalgesia (OIH). Revista Brasileira de Anestesiologia. Elsevier Editora Ltda. https://doi.org/10.1590/S0034-70942010000600011
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