Evidence of opioid-induced hyperalgesia in clinical populations after chronic opioid exposure: a systematic review and meta-analysis.

@article{Higgins2019EvidenceOO,
  title={Evidence of opioid-induced hyperalgesia in clinical populations after chronic opioid exposure: a systematic review and meta-analysis.},
  author={Cassie Higgins and B Holly Smith and Keith Matthews},
  journal={British journal of anaesthesia},
  year={2019},
  volume={122 6},
  pages={
          e114-e126
        }
}
View on PubMed
bjanaesthesia.org
43 Citations
Background Citations
5

43 Citations

Opioid-induced Hyperalgesia in Patients With Chronic Pain
TLDR
The key finding is that clinical symptoms of OIH can be resolved when this condition is diagnosed and managed, and Ketamine and dexmedetomidine were the most widely used adjuvant drugs.
Opioid Treatments for Chronic Pain
TLDR
Outcomes of interest were pain, function, health status/quality of life, mental health outcomes, sleep, doses of opioid used (for comparisons involving opioids and nonopioid therapy) and harms.
Attitudes Towards and Management of Opioid-induced Hyperalgesia
TLDR
OIH is a phenomenon whereby opioids increase patients’ pain sensitivity, complicating their use in analgesia, and practitioners’ attitudes towards, and knowledge concerning diagnosis, risk factors, and treatment of OIH were explored.
Opioid-Induced Tolerance and Opioid-Induced Hyperalgesia in Critical Illness
TLDR
Improved understanding of the underlying mechanisms and diagnosis of opioid tolerance and OIH may be possible to develop strategies to better manage pain associated with critical illness and injury, to improve efficacy and safety of opioid use, and to minimize long-term harms.
Pain management with opioids in adults
TLDR
There remains very little evidence that opioids improve function or quality of life beyond 3 months in people with chronic pain conditions, and there is an urgent need to address these negative consequences of opioid use, in order to maximize the therapeutic benefit that opioids can offer.
Opioid Taper is Associated with Improved Experimental Pain Tolerance in Patients with Chronic Pain: An Observational Study
TLDR
Opioid taper was associated with improvements in experimental pain responses without a decline in function and quality of life, suggestive of diminished opioid-induced hyperalgesia in this clinical sample.
Assessing the impact of SIGN 136 on opioid prescribing rates in Scotland: An interrupted time series analysis
TLDR
The publication of SIGN 136 coincided with a statistically significant reduction in opioid prescribing rates in Scotland and suggests that changes in clinical policy are having a positive effect on prescribing practices in primary care.
Does aerobic exercise effect pain sensitisation in individuals with musculoskeletal pain? A systematic review
TLDR
Evidence is provided that aerobic exercise reduces pain sensitisation in individuals with musculoskeletal pain, and further work is needed to determine whether this translates to improved patient outcomes, including reduced disability and greater quality of life.
Opioid dependence disorder and comorbid chronic pain: comparison of groups based on patient-attributed direction of the causal relationship between the two conditions
TLDR
Two distinct clinical populations were identified, determined by how participants perceive the causal relationship between opioid dependence disorder and chronic pain: those reporting that pain caused opioid dependence Disorder were characterised by poorer pain-related health and more illicit use of drugs with analgesic properties and poorer general health.
How do people who use drugs receiving Opioid Medication Therapy perceive their treatment ? A multicentre study
TLDR
Involving patient points of view in therapeutic strategies decisions could help enhance positive views among PWUD on OMT and help PWUD towards their recovery.
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References

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Incidence of iatrogenic opioid dependence or abuse in patients with pain who were exposed to opioid analgesic therapy: a systematic review and meta‐analysis
Do opioids induce hyperalgesia in humans? An evidence-based structured review.
TLDR
There is not sufficient evidence to support or refute the existence of OIH in humans except in the case of normal volunteers receiving opioid infusions, as measured by secondary hyperalgesia.
A negative correlation between hyperalgesia and analgesia in patients with chronic radicular pain: is hydromorphone therapy a double-edged sword?
TLDR
A 4-week regimen of open-label hydromorphone therapy results in a dose-dependent OIH, which negatively correlates with its analgesic effect, and future randomized, controlled, and blinded studies are needed to verify these preliminary results.
Opioid-induced hyperalgesia: a clinical challenge.
TLDR
Findings are presented that add further weight to the importance of the NMDA receptor in acute OIH, which has the benefits of more closely mimicking the clinical situation than some previous models, and as such their findings may be more directly translatable.
Opioid tolerance and hyperalgesia in chronic pain patients after one month of oral morphine therapy: a preliminary prospective study.
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  • Medicine, Psychology
    The journal of pain : official journal of the American Pain Society
  • 2006
Comparison of pain models to detect opioid-induced hyperalgesia
TLDR
Cold pain is the most suitable of the methods tested to detect opioid-induced hyperalgesia and is consistent with its sensitivity to detect opioids analgesia.
Is opioid-induced hyperalgesia reversible? A study on active and former opioid addicts and drug naïve controls.
TLDR
It is suggested that altered pain perception in OAs is a reversible phenomenon that may require a long period of abstinence to reset, rather than being an individual long-term stable trait.
Opioid-Induced Hyperalgesia
TLDR
Four proposed mechanisms are being considered in the present review to explain OIH including; N-methyl-D-aspartate (NMDA) receptor activation; spinal dynorphin; descending facilitation; and finally decreased reuptake and enhanced nociceptive response.
Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain – New perspective of opioid-induced hyperalgesia
Pain intolerance in opioid-maintained former opiate addicts: effect of long-acting maintenance agent.
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