Opioid-induced Hyperalgesia in Patients With Chronic Pain: A Systematic Review of Published Cases.
Journal
The Clinical journal of pain
ISSN: 1536-5409
Titre abrégé: Clin J Pain
Pays: United States
ID NLM: 8507389
Informations de publication
Date de publication:
26 10 2021
26 10 2021
Historique:
received:
22
05
2021
accepted:
28
09
2021
pubmed:
27
10
2021
medline:
3
2
2022
entrez:
26
10
2021
Statut:
epublish
Résumé
Opioid-induced hyperalgesia (OIH) remains an issue in patients with chronic pain. Multiple cases of OIH in patients with chronic pain exposed to opioids have been reported worldwide. The objective of this systematic review was to summarize the evidence of OIH from clinical reports. We searched the PubMed, Cochrane, EMBASE, and LILACS databases for case reports and case series of OIH published up to December 2020, with the aim to summarize the evidence for OIH in patients with chronic pain from clinical reports and to discuss issues relevant to the clinical diagnosis and management of OIH. We retrieved and reviewed 41 articles describing 72 cases. Clinical features of OIH were observed in patients of both sexes, all ages, and with various types of pain treated with different classes of opioids. OIH was reported at all doses, but most published studies reported a pattern of OIH following treatment with very high daily doses of opioids (median oral morphine equivalent dose of 850 mg). OIH was diagnosed clinically in all cases. Three different strategies for OIH management were described: opioid rotation, opioid cessation, and the use of adjuvant pharmacotherapies. All had statistically similar success rates for OIH treatment: 72%, 57%, and 79%, respectively. The decrease in pain was achieved rapidly (mean: 8 d; range: 1 to 28 d). Adjuvant therapies resulted in the largest decrease in dose. Ketamine and dexmedetomidine were the most widely used adjuvant drugs. The key finding is that clinical symptoms of OIH can be resolved when this condition is diagnosed and managed.
Identifiants
pubmed: 34699405
doi: 10.1097/AJP.0000000000000994
pii: 00002508-202201000-00007
doi:
Substances chimiques
Analgesics, Opioid
0
Morphine
76I7G6D29C
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-57Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
This work used only institutional resources. V.M. has received payments and travel funding for lectures from Mylan, Grunenthal. The remaining authors declare no conflict of interest.
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