Santonocito Cristina, Noto Alberto, Crimi Claudia, Sanfilippo Filippo
Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
Department of Anesthesia and Intensive Care, Messina University, Messina, Italy.
Local Reg Anesth. 2018 Apr 9;11:15-23. doi: 10.2147/LRA.S143618. eCollection 2018.
The use of remifentanil in clinical practice offers several advantages and it is used for a wide range of procedures, ranging from day-surgery anesthesia to more complex procedures. Nonetheless, remifentanil has been consistently linked with development of opioid-induced hyperalgesia (OIH), which is described as a paradoxical increase in sensitivity to painful stimuli that develops after exposure to opioid treatment. The development of OIH may cause several issues, delaying recovery after surgery and preventing timely patient's discharge. Moreover, it causes patient's discomfort with higher pain scores, greater use of analgesics, and associated side effects. Remifentanil is the opioid most convincingly associated with OIH, and hereby we provide a review of remifentanil-induced hyperalgesia, describing both the underlying mechanisms involved and the available studies investigating experimental and clinical pharmacologic approaches aiming at reducing its incidence and degree.
瑞芬太尼在临床实践中的应用具有诸多优势，它被用于广泛的手术过程，从日间手术麻醉到更为复杂的手术。尽管如此，瑞芬太尼一直与阿片类药物诱导的痛觉过敏（OIH）的发生有关，OIH被描述为在接受阿片类药物治疗后对疼痛刺激的敏感性出现反常增加。OIH的发生可能引发若干问题，延迟术后恢复并阻碍患者及时出院。此外，它会导致患者不适，表现为疼痛评分更高、更多地使用镇痛药以及相关的副作用。瑞芬太尼是与OIH关联最为确凿的阿片类药物，在此我们对瑞芬太尼诱导的痛觉过敏进行综述，描述其中涉及的潜在机制以及旨在降低其发生率和程度的研究实验和临床药理学方法的现有研究。
