Mamie C
Unité d'anesthésie pédiatrique, division d'anesthésiologie, hôpitaux universitaires de Genève, Suisse.
Ann Fr Anesth Reanim. 2012 Jan;31(1):e39-42. doi: 10.1016/j.annfar.2011.11.002. Epub 2011 Dec 15.
Three types of hyperalgesia can occur during the postoperative period: primary hyperalgesia, which disappears with wound healing, secondary or central hyperalgesia, which can lead to chronic pain, and opiate-induced hyperalgesia. Different drugs, most of which are NMDA receptors antagonists, are used to decrease or prevent the risk of central or opiate-induced hyperalgesia. However, it is difficult to determine whether they are really effective and at which dosage: the results of most published studies are difficult to interpret because of methodological problems. The two most frequent of those are: absence of objective measurement of secondary hyperalgesia and difficulties targeting an at risk population.
原发性痛觉过敏,会随着伤口愈合而消失;继发性或中枢性痛觉过敏,可能导致慢性疼痛;以及阿片类药物诱导的痛觉过敏。人们使用不同的药物(其中大多数是N-甲基-D-天冬氨酸受体拮抗剂)来降低或预防中枢性或阿片类药物诱导的痛觉过敏风险。然而,很难确定它们是否真的有效以及使用何种剂量:由于方法学问题,大多数已发表研究的结果难以解释。其中最常见的两个问题是:缺乏对继发性痛觉过敏的客观测量,以及难以确定高危人群。