Side effect profiles of different opioids in the perioperative setting: are they different and can we reduce them?

Shim, Hoon; Gan, Tong J.

doi:10.1016/j.bja.2019.06.009

Cited by 17 publications

(11 citation statements)

References 27 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have confirmed that opioids can safely exert cardioprotective effects both in basic research and in clinical applications [1][2][3][4]. However, the use of opioids is associated with numerous side effects, such as nausea and vomiting, constipation, urinary retention, postoperative ileus, pruritus, respiratory depression and sedation [5]. Additionally, the severity of the side effects is related to the dosage and route of administration.…”

Section: Introductionmentioning

confidence: 95%

Effects of nalbuphine on the cardioprotective effect of morphine in rats

Wang

et al. 2021

International Journal of Cardiology

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 95%

Effects of nalbuphine on the cardioprotective effect of morphine in rats

Wang

et al. 2021

International Journal of Cardiology

View full text Add to dashboard Cite

“…A number of MOR agonists, such as morphine, have been reported to be effective in alleviating severe pain; however, there were obvious limitations, such as they are prone to abuse, which is associated with an increased, risk of overdose, and serious side effects ( 30 ). In addition, several studies on morphine have shown that it promotes the proliferation, apoptosis, migration, and invasion in the breast ( 22 , 31 ), lung ( 6 , 32 , 33 ) and colorectal cancer cell lines ( 34 ), and a few studies indicated that morphine has an anti-tumor effect ( 35 , 36 ).…”

Section: Discussionmentioning

confidence: 99%

Agonists Specific for κ-Opioid Receptor Induces Apoptosis of HCC Cells Through Enhanced Endoplasmic Reticulum Stress

Tan¹,

Wang²,

Cheng³

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

Cancer pain is an important factor affecting life quality of patients especially in the advanced stage and relieving pain is one of fundamental strategies for cancer treatment. Opioids such as morphine are the most widely used in clinics. However, they have been reported to be associated with the occurrence and development of several types of cancer. Thus, search for an opioid that has analgesic effect and can retard cancer progress simultaneously is critical for cancer management. In this study, we first examined the expression of μ and κ (MOR and KOR) in cell lines and tumor tissues of hepatocellular carcinoma (HCC), a malignant tumor with high mortality, and then compared the effects of opioid receptors-specific agonists on malignant phenotypes of HCC cells in vitro and tumor growth in an HCC xenograft mouse model. KOR and MOR were found to be highly expressed in HCC cell lines and HCC tissues. The KOR-specific agonist U50488h, oxycodone (agonist for both KOR and MOR) and the MOR-specific agonist morphine inhibited HCC cell proliferation, while only U50488h and oxycodone suppressed colony formation and migration of HCC cells. U50488h and oxycodone, but not morphine, induced HCC apoptosis. Further detection of PERK, GRP78 and CHOP revealed that PERK signaling was upregulated by treatment with U50488h, while treatment with the PERK inhibitor GSK2656157 partially reversed the promotion of apoptosis and inhibition of cell proliferation by U50488h, indicating that endoplasmic reticulum stress is associated with its suppressing effect on HCC malignant phenotypes. Similar to the in vitro results, HCC growth was significantly reduced by administration of U50488h and oxycodone, but not by morphine, in the HCC xenograft mouse model. PERK and caspase-3 in the HCC tissues were up-regulated by U50488h treatment as detected by immunohistochemistry and western blotting. Taken together, our results revealed that activation of KOR by U50488h inhibited malignant phenotypes of HCC both in vitro and in vivo, while activation of MOR by morphine did not have such effect. Because of their dual roles in the relief of pain and in the suppression of malignant phenotypes, opioids such as U50488h that act on KOR should be considered as the first choice for HCC management.

show abstract

“…Therefore, we speculated that reduced opioid consumption may similarly lead to the inhibition of hyperfunction in parathyroid cells and decrease the risk of SHPT recurrence. Meanwhile, with the development of opioid-sparing anesthesia, patients exhibit a better prognosis for multiple surgeries [21,22]. As we know, patients with ESRD usually experience substantial physical, emotional, mental, and psychological impairments that are re ected in the decreased QOL [13,23].…”

Section: Discussionmentioning

confidence: 99%

Impact of Dexmedetomidine On Secondary Hyperparathyroidism Recurrence In Uremic Patients Who Received Parathyroidectomy With Auto-Transplantation: A Retrospective Propensity-Matched Study

Han

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Recurrence of secondary hyperparathyroidism (SHPT) remains a big challenge in uremic patients who underwent total parathyroidectomy with auto-transplantation (tPTX-AT). However, the relationship between perioperative intervention and recurrence of SHPT remains unclear. Dexmedetomidine has been used safely and effectively in uremic patients’ anesthesia. The aim of the study was to explore the effect of dexmedetomidine on the recurrence of SHPT and speculate the possible mechanism of action.Methods: Records of patients who underwent tPTX-AT between 2017 and 2018 were retrospectively analyzed. The study consisted of patients who received dexmedetomidine intra-operatively and the controls were patients who did not receive dexmedetomidine. The primary endpoint was the difference in the recurrence of SHPT one year after surgery between the two groups. The secondary endpoint was health-related quality of life scores. Analysis included propensity score matching and multivariable logistic regression. Results: Of 354 patients, 133 patients received dexmedetomidine intraoperatively, and the total recurrence rate of SHPT was 10.2%. After propensity score matching, patients who received dexmedetomidine had a 3.80-fold decreased risk of SHPT recurrence (odds ratio, 0.263; 95% confidence interval, 0.081 to 0.854; P=0.026) and exhibited a better quality of life in terms of physical functioning and general health, and less emotional role limitations compared with those in control group.Conclusion: In uremic patients who received tPTX-AT, there was an association between dexmedetomidine use and decreased risk of SHPT recurrence. Further studies are needed to accurately assess the effects and mechanism of action of dexmedetomidine on the prognosis of this population.

show abstract

Side effect profiles of different opioids in the perioperative setting: are they different and can we reduce them?

Cited by 17 publications

References 27 publications

Effects of nalbuphine on the cardioprotective effect of morphine in rats

Effects of nalbuphine on the cardioprotective effect of morphine in rats

Agonists Specific for κ-Opioid Receptor Induces Apoptosis of HCC Cells Through Enhanced Endoplasmic Reticulum Stress

Impact of Dexmedetomidine On Secondary Hyperparathyroidism Recurrence In Uremic Patients Who Received Parathyroidectomy With Auto-Transplantation: A Retrospective Propensity-Matched Study

Contact Info

Product

Resources

About