| No hyperalgesia following opioid withdrawal after the oripavine derivative etorphine compared to remifentanil and sufentanil. | |
| | |
MedLine Citation:
|
PMID: 20077594 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND OBJECTIVE: The concept of opioid-induced hyperalgesia has recently gained prominence as a contributing factor for long-term treatment failure. METHODS: To evaluate possible differences of opioids used in anaesthesia, cumulative doses of sufentanil and remifentanil were compared with escalating doses of the oripavine derivative etorphine, in awake and trained canines. This was followed by naloxone unmasking a possible hyperalgesic state, which had developed during opioid administration. Heart rate, blood pressure and propagation of nociceptive volleys in somatosensory-evoked potentials as well as the skin-twitch reflex were evaluated. RESULTS: Opioid-related hypotension and bradycardia were reversed by naloxone with a late (30 min) overshoot of R43 and R17% after remifentanil and sufentanil, respectively. Following etorphine, overshoot in mean blood pressure was R9%, whereas heart rate still remained below S9% when compared with control. Peak hyperalgesia, as detected in the somatosensory-evoked potential and skin-twitch, increased by R70% after remifentanil and by R43% after sufentanil. This reflected a significant (P<0.005) increase in propagation of nociceptive afferents as late as 30 min after naloxone reversal. Such potentiation was not observed in the etorphine group, as peak somatosensory-evoked potential deflection and skin-twitch remained below S80% when compared with control. CONCLUSION: The pure mu-agonists sufentanil or remifentanil seem to induce a 'bimodal' inhibitory followed by an excitatory effect. The latter is unmasked by naloxone in the postadministration period. In contrast, this is not seen with etorphine, a close congener of buprenorphine. The proposed mode of action of such hyperexcitatory effects may involve second-messenger-mediated G-protein activation, originally proposed by others. Ligands of the oripavine series may present an alternative for prevention of opioid-induced hyperalgesia in patients. |
| | |
Authors:
|
Enno Freye; Joseph V Levy |
Related Documents
:
|
2006594 - Injection pain, intubating conditions and cardiovascular changes following induction of... 3919524 - Comparison of alfentanil and fentanyl as supplements to induction of anaesthesia with t... 2125264 - Cardiopulmonary effects of epidurally administered xylazine in the horse. 21440254 - Tracking the scapula using the scapula locator with and without feedback from pressure-... 2459674 - The usefulness of head-up tilt testing and hemodynamic investigations in the workup of ... 19899324 - Clinical, electrodiagnostic and pedobarographic assessments of leprotic patients with t... |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: European journal of anaesthesiology Volume: 27 ISSN: 1365-2346 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2010 Feb |
Date Detail:
|
Created Date: 2010-01-14 Completed Date: 2010-03-30 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
|
Languages: eng Pagination: 174-80 Citation Subset: IM |
Affiliation:
|
Clinics of Vascular Surgery, University Clinics of Duesseldorf, Duesseldorf, Germany. enno.freye@uni-duesseldorf.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Afferent Pathways
/
drug effects Analgesics, Opioid / administration & dosage, toxicity* Animals Blood Pressure / drug effects Bradycardia / chemically induced Dogs Dose-Response Relationship, Drug Etorphine / administration & dosage, toxicity* Evoked Potentials, Somatosensory / drug effects Heart Rate / drug effects Hyperalgesia / chemically induced Hypotension / chemically induced Naloxone / pharmacology Narcotic Antagonists / pharmacology Piperidines / administration & dosage, toxicity* Substance Withdrawal Syndrome Sufentanil / administration & dosage, toxicity* |
| Chemical | |
Reg. No./Substance:
|
0/Analgesics, Opioid; 0/Narcotic Antagonists; 0/Piperidines; 132875-61-7/remifentanil; 14521-96-1/Etorphine; 465-65-6/Naloxone; 56030-54-7/Sufentanil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The impact of climate change on mental health (but will mental health be discussed at Copenhagen?)...
Next Document: Provider factors affecting adherence: cultural competency and sensitivity.