Methods for the assessment of opioid-induced hyperalgesia in the perioperative period

Leal, Plínio da Cunha; Sakata, Rioko Kimiko

doi:10.5935/1806-0013.20140064

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Although OIH has been cited as a potential cause of opioid dose-escalation without resultant analgesia, veritable proof of that notion is relatively limited. Most of the studies proposing this are either in vitro or on animals [ 23 , 24 , 25 , 26 , 27 ], in the post-operative acute pain setting [ 3 , 11 , 15 , 28 , 29 , 30 , 31 , 32 ], or in healthy volunteers [ 33 ]. Only a few studies have discussed chronic non-cancer pain [ 34 ] and palliative care [ 16 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

Opioid Induced Hyperalgesia, a Research Phenomenon or a Clinical Reality? Results of a Canadian Survey

Vargas-Schaffer

Paquet

Neron

et al. 2020

JPM

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Background: Very little is known regarding the prevalence of opioid induced hyperalgesia (OIH) in day to day medical practice. The aim of this study was to evaluate the physician’s perception of the prevalence of OIH within their practice, and to assess the level of physician’s knowledge with respect to the identification and treatment of this problem. Methods: An electronic questionnaire was distributed to physicians who work in anesthesiology, chronic pain, and/or palliative care in Canada. Results: Of the 462 responses received, most were from male (69%) anesthesiologists (89.6%), in the age range of 36 to 64 years old (79.8%). In this study, the suspected prevalence of OIH using the average number of patients treated per year with opioids was 0.002% per patient per physician practice year for acute pain, and 0.01% per patient per physician practice year for chronic pain. Most physicians (70.2%) did not use clinical tests to help make a diagnosis of OIH. The treatment modalities most frequently used were the addition of an NMDA antagonist, combined with lowering the opioid doses and using opioid rotation. Conclusions: The perceived prevalence of OIH in clinical practice is a relatively rare phenomenon. Furthermore, more than half of physicians did not use a clinical test to confirm the diagnosis of OIH. The two main treatment modalities used were NMDA antagonists and opioid rotation. The criteria for the diagnosis of OIH still need to be accurately defined.

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