Publication Date
4-1-2021
Journal
Pain Management
DOI
10.2217/pmt-2020-0105
PMID
33779215
PMCID
PMC8023328
PubMedCentral® Posted Date
3-29-2021
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Analgesics, Opioid, Humans, Hyperalgesia, Pain, analgesics, CNS sensitization, drug tolerance, hyperalgesia, opioid, opioid-related disorders, somatosensory disorders
Abstract
Opioid-induced hyperalgesia (OIH) occurs when opioids paradoxically enhance the pain they are prescribed to ameliorate. To address a lack of perioperative awareness, we present an educational review of clinically relevant aspects of the disorder. Although the mechanisms of OIH are thought to primarily involve medullary descending pathways, it is likely multifactorial with several relevant therapeutic targets. We provide a suggested clinical definition and directions for clinical differentiation of OIH from other diagnoses, as this may be confusing but is germane to appropriate management. Finally, we discuss prevention including patient education and analgesic management choices. As prevention may serve as the best treatment, patient risk factors, opioid mitigation, and both pharmacologic and non-pharmacologic strategies are discussed.
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Medical Sciences Commons, Medical Specialties Commons, Pain Management Commons, Substance Abuse and Addiction Commons