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Remifentanil induced hyperalgesia

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https://www.readbyqxmd.com/read/28222697/magnesium-sulphate-attenuate-remifentanil-induced-postoperative-hyperalgesia-via-regulating-tyrosine-phosphorylation-of-the-nr2b-subunit-of-the-nmda-receptor-in-the-spinal-cord
#1
Jiehao Sun, Hai Lin, Guodong He, Wendong Lin, Jianping Yang
BACKGROUND: Remifentanil induced hyperalgesia (RIH) is characterized by stimulation evoked pain including allodynia and thermal hyperalgesia after remifentanil infusion. N-methyl-D-aspartate (NMDA) receptor was reported to be involved in the progress of RIH. We hypothesized that intrathecal MgSO4 could relieve hyperalgesia after remifentanil infusion via regulating phosphorylation of NMDA receptor NR2B subunit activity in this study. METHODS: Thirty two rats were randomly allocated into control group, model of RIH group, RIH plus 100ug MgSO4 group, RIH plus 300ug MgSO4 group...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28199982/n-acetyl-cysteine-attenuates-remifentanil-induced-postoperative-hyperalgesia-via-inhibiting-matrix-metalloproteinase-9-in-dorsal-root-ganglia
#2
Yue Liu, Yuan Ni, Wei Zhang, Yu-E Sun, Zhengliang Ma, Xiaoping Gu
Treatment of remifentanil-induced postoperative hyperalgesia (RIH) remains a clinical challenge because the mechanisms are not fully understood. Matrix metalloproteinase-9 (MMP-9) is a key component in neuroinflammation because of its facilitation of pro-inflammatory cytokine maturation. Therefore, inhibition of MMP-9 may represent a novel therapeutic approach to the treatment of RIH. Sprague-Dawley rats were randomly divided into three groups: Control, Incision and Remifentanil. A right plantar surgical incision was performed in Group Incision, and intraoperative remifentanil (0...
February 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28182698/prevention-of-remifentanil-induced-postoperative-hyperalgesia-by-dexmedetomidine-via-regulating-the-trafficking-and-function-of-spinal-nmda-receptors-as-well-as-pkc-and-camkii-level-in-vivo-and-in-vitro
#3
Yuan Yuan, Zhe Sun, Yi Chen, Yuxin Zheng, Ke-Liang Xie, Ying He, Zhifen Wang, Guo-Lin Wang, Yong-Hao Yu
Remifentanil-induced secondary hyperalgesia has been demonstrated in both animal experiments and clinical trials. Enhancement of N-methyl-D-aspartate (NMDA) receptor trafficking as well as protein kinase C (PKC) and calmodulin-dependent protein kinase II (CaMKII) have been reported to be involved in the induction and maintenance of central sensitization. In the current study, it was demonstrated that dexmedetomidine could prevent remifentanil-induced hyperalgesia (RIH) via regulating spinal NMDAR-PKC-Ca2+/ CaMKII pathway in vivo and in vitro...
2017: PloS One
https://www.readbyqxmd.com/read/28077539/preoperative-butorphanol-and-flurbiprofen-axetil-therapy-attenuates-remifentanil-induced-hyperalgesia-after-laparoscopic-gynaecological-surgery-a-randomized-double-blind-controlled-trial
#4
L Zhang, R Shu, Q Zhao, Y Li, Y Yu, G Wang
BACKGROUND: Several studies indicate that remifentanil exposure may engender opioid-induced hyperalgesia. Butorphanol and flurbiprofen axetil are proposed as adjunctive analgesics for postoperative pain control. This randomized double-blind controlled study was designed to investigate the antihyperalgesic effects of butorphanol combined with flurbiprofen axetil on opioid-induced hyperalgesia. METHODS: One hundred and twenty patients undergoing elective laparoscopic gynaecological surgery with sevoflurane anaesthesia were randomized to one of four groups, as follows: intraoperative sufentanil 0...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28039043/cathepsin-s-in-the-spinal-microglia-contributes-to-remifentanil-induced-hyperalgesia-in-rats
#5
L Ye, L Xiao, S Y Yang, J J Duan, Y Chen, Y Cui, Y Chen
Cysteine protease Cathepsin S (CatS) expressed by spinal microglia has been shown to play a critical role in nerve injury and inflammation-induced chronic pain. However, whether microglial CatS contributes to remifentanil-induced acute hyperalgesia remains unstudied. In the present study, intravenous remifentanil infusion induced a significant increase in the expression of premature and mature form of CatS in the activated microglia in the spinal cord. Spinal delivery of irreversible CatS inhibitor LHVS reduced hyperalgesia, attenuated activation of spinal microglia and blocked phosphorylation of NMDA receptor NR1 subunit induced by remifentanil...
March 6, 2017: Neuroscience
https://www.readbyqxmd.com/read/27744107/a-targeted-remifentanil-administration-protocol-based-on-the-analgesia-nociception-index-during-vascular-surgery
#6
Georges Daccache, Edouard Caspersen, Michel Pegoix, Kelly Monthé-Sagan, Ludovic Berger, Dominique Fletcher, Jean-Luc Hanouz
BACKGROUND: The intraoperative modulation of opioids continues to be based on clinical signs. This may result in adverse events such as sympathetic reactivity or opioid-induced hyperalgesia. Recently, the Analgesia/Nociception Index (ANI), a non-invasive 0-100 index derived from heart rate variability analysis, has been proposed for nociception assessment. However, the ability of the ANI to adequately guide intraoperative opioid administration has never been demonstrated. We designed a prospective study to evaluate the ability of the ANI to guide remifentanil administration in vascular surgery...
October 12, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27741140/effects-of-remifentanil-versus-nitrous-oxide-on-postoperative-nausea-vomiting-and-pain-in-patients-receiving-thyroidectomy-propensity-score-matching-analysis
#7
Min Kyoung Kim, Myung Sub Yi, Hyun Kang, Geun-Joo Choi
Remifentanil and nitrous oxide (N2O) are 2 commonly used anesthetic agents. Both these agents are known risk factors for postoperative nausea and vomiting (PONV). However, remifentanil and N2O have not been directly compared in a published study. Remifentanil can induce acute tolerance or hyperalgesia, thus affecting postoperative pain. The objective of this retrospective study is to compare the effects of remifentanil and N2O on PONV and pain in patients receiving intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27734470/remifentanil-tolerance-and-hyperalgesia-short-term-gain-long-term-pain
#8
REVIEW
E H Y Yu, D H D Tran, S W Lam, M G Irwin
The unique pharmacology of remifentanil makes it a popular intra-operative analgesic. Short-acting opioids like remifentanil have been associated with acute opioid tolerance and/or opioid-induced hyperalgesia, two phenomena which have different mechanisms and are pharmacologically distinct. Clinical studies show heterogeneity of remifentanil infusion regimens, durations of infusion, maintenance of anaesthesia, cumulative dose of remifentanil and pain measures, which makes it difficult to draw conclusions about the incidence of acute tolerance or hyperalgesia...
November 2016: Anaesthesia
https://www.readbyqxmd.com/read/27703629/comparison-of-effects-of-intraoperative-nefopam-and-ketamine-infusion-on-managing-postoperative-pain-after-laparoscopic-cholecystectomy-administered-remifentanil
#9
Sung Kwan Choi, Myung Ha Yoon, Jung Il Choi, Woong Mo Kim, Bong Ha Heo, Keun Seok Park, Ji A Song
BACKGROUND: Although intraoperative opioids provide more comfortable anesthesia and reduce the use of postoperative analgesics, it may cause opioid induced hyperalgesia (OIH). OIH is an increased pain response to opioids and it may be associated with N-methyl-D-aspartate (NMDA) receptor. This study aimed to determine whether intraoperative nefopam or ketamine, known being related on NMDA receptor, affects postoperative pain and OIH after continuous infusion of intraoperative remifentanil...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27698764/protective-effects-of-dexmedetomidine-combined-with-flurbiprofen-axetil-on-remifentanil-induced-hyperalgesia-a-randomized-controlled-trial
#10
Zenggui Yu, Weilan Wu, Xiaodan Wu, Hongyi Lei, Cansheng Gong, Shiyuan Xu
High dosages of intra-operative remifentanil are associated with opioid-induced hyperalgesia (OIH). The aim of the present study was to investigate the effect of combined dexmedetomidine and flurbiprofen axetil treatment on remifentanil-induced hyperalgesia. Patients with an American Society of Anesthesiologists physical status of I-II who were diagnosed with hysteromyoma and scheduled for laparoscopic assisted vaginal hysterectomy (LAVH) were randomly divided into three groups. Group hyperalgesia (Group H, n=29) received intra-operative remifentanil, Group hyperalgesia and dexmedetomidine (Group HD, n=28) received remifentanil and a continuous infusion of dexmedetomidine, and Group hyperalgesia, dexmedetomidine and flurbiprofen axetil (Group HDF, n=29) received remifentanil, flurbiprofen axetil and dexmedetomidine...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27687719/the-role-of-p38mapk-activation-in-spinal-dorsal-horn-in-remifentanil-induced-postoperative-hyperalgesia-in-rats
#11
Liqin Deng, Lihua Zhang, Haiying Zhao, Fengxiang Song, Gang Chen, Hanyue Zhu
OBJECTIVES: Remifentanil may induce hyperalgesia. Recent studies implicate a close relationship between post-surgical hyperalgesia and phosphorylation and activation of p38 mitogen-activated protein kinase (p38MAPK) in the spinal microglia. This study aimed to investigate whether the combination of post-surgical and remifentanil-induced hyperalgesia worsens post-operative pain and whether phosphorylated p38MAPK (phospho-p38MAPK) in the spinal dorsal horn in rats is involved in remifentanil-induced postoperative hyperalgesia...
October 2016: Neurological Research
https://www.readbyqxmd.com/read/27687343/low-dose-butorphanol-alleviates-remifetanil-induced-hyperalgesia-in-patients-undergoing-laparoscopic-cholecystectomy
#12
Mingjian Kong, Li Yang, Jing Li, Zheng Zhong, Yanqiang Cheng, Zhen Wu, Ran Guo
OBJECTIVE: To evaluate the effects of low-dose butorphanol on hyperalgesia induced by high-dose remifetanil in patients undergoing laparoscopic cholecystectomy. DESIGN: Randomized double-blind clinical trial. SETTING: Intraoperative. PATIENTS: Seventy-five patients scheduled for laparoscopic cholecystectomy were enrolled. INTERVENTIONS: Randomly allocated into 3 groups, low dose of remifentanil (LR) group and high dose of remifentanil (HR) group received low (0...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27637388/spinal-mitochondrial-derived-ros-contributes-to-remifentanil-induced-postoperative-hyperalgesia-via-modulating-nmda-receptor-in-rats
#13
Liu Ye, Li Xiao, Xue Bai, Shi-Ying Yang, Yuan Li, Yuan Chen, Y Cui, Y Chen
BACKGROUND: Activation of N-methyl-d-aspartate (NMDA) receptor by reactive oxygen species (ROS) in the spinal cord plays an important role in the development of hyperalgesia in several neuropathic pain models. The study examined the involvement of ROS-NMDA signaling pathway in remifentanil-induced postoperative hyperalgesia. METHODS: Nociceptive responses were measured by paw withdrawal mechanical threshold (PWT) and paw withdrawal thermal latency (PWL) before and up to day 5 after remifentanil infusion...
September 13, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27616703/spinal-wnt-pathway-contributes-to-remifentanil-induced-hyperalgesia-through-regulating-fractalkine-and-cx3cr1-in-rats
#14
Gu Gong, Ling Hu, Fuen Qin, Liang Yin, Xiaobo Yi, Libang Yuan, Wei Wu
BACKGROUND: Tremendous experimental and clinical studies identify that remifentanil anesthesia might elicit postoperative opioid-induced hyperalgesia (OIH) and aggravate nociceptive hypersensitivity, whereas definite mechanisms remain equivocal. WNT signaling and fractalkine pathway have been manifested to participate in varieties of pain pathogenesis, respectively, but no report is on whether they could lead to OIH. This study intended to investigate the effect of WNT3a/β-catenin on fractalkine and its receptor CX3CR1 in OIH in rats model of incision pain...
October 28, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27599837/a-comparison-of-intrathecal-magnesium-and-ketamine-in-attenuating-remifentanil-induced-hyperalgesia-in-rats
#15
Jiehao Sun, Hai Lin, Xiaona Feng, Jiaojiao Dong, Emmanuel Ansong, Xuzhong Xu
BACKGROUND: Activation of NMDA receptors play an important role in the development of remifentanil-induced hyperalgesia. We hypothesized that in addition to ketamine, intrathecal MgSO4 could also relieve thermal and mechanical hyperalgesia in rats. METHODS: Initially, 24 Sprague-Dawley rats were divided into control group, remifentanil group, surgical incision group and remifentanil combined with surgical incision group to create an experimental model. Subsequently, 40 rats were divided into control group, model group, model group plus 100 μg MgSO4, 300 μg MgSO4 and 10 μg ketamine respectively...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27537764/pick1-regulates-the-expression-and-trafficking-of-ampa-receptors-in-remifentanil-induced-hyperalgesia
#16
Zhifen Wang, Yuan Yuan, Keliang Xie, Xiaohong Tang, Linlin Zhang, Jiying Ao, Nan Li, Yu Zhang, Suqian Guo, Guolin Wang
BACKGROUND: Remifentanil is used widely in clinical anesthesia because it induces more rapid and more common hyperalgesia than other opioid analgesics. Activation of N-methyl-D-aspartate (NMDA) receptors takes a pivotal part in remifentanil-induced hyperalgesia. Like NMDA receptors, the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) are excitatory ion glutamate receptors in postsynaptic membrane, which are involved in the transmission of both acute and chronic pain...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27518488/preoperative-but-not-postoperative-flurbiprofen-axetil-alleviates-remifentanil-induced-hyperalgesia-after-laparoscopic-gynecological-surgery-a-prospective-randomized-double-blinded-trial
#17
Linlin Zhang, Ruichen Shu, Qi Zhao, Yize Li, Chunyan Wang, Haiyun Wang, Yonghao Yu, Guolin Wang
BACKGROUND: Acute remifentanil exposure during intraoperative analgesia might generate sensitivity-enhancing to noxious stimuli and nociceptive responses to innoxious irritation. Cyclooxygenase inhibition was demonstrated to attenuate experimental remifentanil-induced hyperalgesia (RIH) in rodents and human volunteers. the study aimed to compare effects of preoperative and postoperative flurbiprofen axetil on RIH after surgery. METHODS: Ninety patients undergoing elective laparoscopic gynaecological surgery were randomly assigned to receive either intravenous placebo before anesthesia induction (group C); or intravenous flurbiprofen axetil 1...
August 11, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27388980/influence-of-intraoperative-remifentanil-and-sufentanil-on-sensory-perception-a-randomized-trial
#18
H Ohnesorge, A Alpes, R Baron, J Gierthmühlen
OBJECTIVE: The clinical relevance of pro- and hyperalgesic effects of opioids is still a matter of debate. Particularly for remifentanil, an increased postoperative need for analgesics has been demonstrated suggesting opioid-induced hyperalgesia as a possible cause. The aim of the study was therefore to investigate the effect of intraoperatively applied remifentanil compared to sufentanil on somatosensory thresholds investigated with the quantitative sensory testing (QST) battery of the German Research Network on Neuropathic Pain (DFNS)...
July 8, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27380044/involvement-of-spinal-pkm%C3%AE-expression-and-phosphorylation-in-remifentanil-induced-long-term-hyperalgesia-in-rats
#19
Qi Zhao, Linlin Zhang, Ruichen Shu, Chunyan Wang, Yonghao Yu, Haiyun Wang, Guolin Wang
Up-regulation of GluN2B-containing N-methyl-D-aspartate receptors (NMDARs) expression and trafficking is the key mechanism for remifentanil-induced hyperalgesia (RIH), nevertheless, the signaling pathway and pivotal proteins involved in RIH remain equivocal. PKMζ, an isoform of protein kinase C (PKC), maintains pain memory storage in neuropathic pain and inflammatory pain, which plays a parallel role regulated by NMDARs in long-term memory trace. In the present study, Zeta Inhibitory Peptide (ZIP), a PKMζ inhibitor, and a selective GluN2B antagonist Ro-256981 are injected intrathecally before remifentanil infusion (1 μg kg(-1) min(-1) for 1 h, iv) in order to detect whether GluN2B contributes to RIH through affecting synthesis and activity of PKMζ in spinal dorsal horn...
July 5, 2016: Cellular and Molecular Neurobiology
https://www.readbyqxmd.com/read/27185670/remifentanil-and-worse-patient-reported-outcomes-regarding-postoperative-pain-management-after-thyroidectomy
#20
MULTICENTER STUDY
Filippo Sanfilippo, Caren Conticello, Cristina Santonocito, Carmelo Minardi, Filippo Palermo, Renato Bernardini, Antonino Gullo, Marinella Astuto
BACKGROUND: Intraoperative remifentanil has been associated with postoperative hyperalgesia, higher visual analogic pain scores, and increased postoperative morphine consumption. However, this has not been investigated from patient's perspective by using a patient-reported outcomes (PROs) approach with a validated questionnaire. METHODS: We joined the largest prospective observational study on postoperative pain, PAIN OUT Project (NCT02083835), and collected data for 2 years...
June 2016: Journal of Clinical Anesthesia
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