Gradual withdrawal of remifentanil infusion may prevent opioid-induced hyperalgesia
Gradual withdrawal of remifentanil infusion may prevent opioid-induced hyperalgesia
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DOI：
10.1093/bja/aev547
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发表时间：
2016-04-01
影响因子：
9.8
通讯作者：
Lenz, H.
中科院分区：
文献类型：
--
作者：
Comelon, M.;Raeder, J.;Lenz, H.
背景：这项研究的目的是检验逐渐停用瑞芬太尼是否能预防阿片类药物诱导的痛觉过敏(OIH)，而不是突然停药。方法：19名志愿者参加了这项随机、双盲、安慰剂对照的交叉研究。所有患者都经历了三个疗程：突然或逐渐停用瑞芬太尼输液和安慰剂。瑞芬太尼以2.5ngml(-1)静注30min后突然停药或以0.6ngml(-1)每5min逐步停药一次。结果：用热疼痛试验(HPT)和冷加压试验(CPT)评价输液结束后45分钟、105分钟和110分钟的疼痛情况。结果：输液后45分钟的HPT提示OIH发生在突然戒断阶段，疼痛评分高于逐渐戒断和安慰剂组(均P
Background: The aim of this study was to examine if gradual withdrawal of remifentanil infusion prevented opioid-induced hyperalgesia (OIH) as opposed to abrupt withdrawal. OIH duration was also evaluated.Methods: Nineteen volunteers were enrolled in this randomized, double-blinded, placebo-controlled, crossover study. All went through three sessions: abrupt or gradual withdrawal of remifentanil infusion and placebo. Remifentanil was administered at 2.5 ng ml(-1) for 30 min before abrupt withdrawal or gradual withdrawal by 0.6 ng ml(-1) every five min. Pain was assessed at baseline, during infusion, 45-50 min and 105-110 min after end of infusions using the heat pain test (HPT) and the cold pressor test (CPT).Results: The HPT 45 min after infusion indicated OIH development in the abrupt withdrawal session with higher pain scores compared with the gradual withdrawal and placebo sessions (both P