Opioid-Induced Hyperalgesia in the Nonsurgical Setting: A Systematic Review

  title={Opioid-Induced Hyperalgesia in the Nonsurgical Setting: A Systematic Review},
  author={David Z Yang and Billy Sin and Joshua Beckhusen and Dawei Xia and Rebecca Khaimova and Ilia Iliev},
  journal={American Journal of Therapeutics},
Background: Opioid-induced hyperalgesia (OIH) is a phenomenon that causes an increased pain sensitization and perception of pain to noxious stimuli secondary to opioid exposure. [] Key Method This review included randomized controlled trials with objectives to identify OIH in the nonsurgical setting. The clinical outcomes of interest were identification of OIH, adverse events, and impact of OIH on opioid consumption. Results: The search identified 8 studies that fulfilled the criteria.
Opioid-induced Hyperalgesia in Patients With Chronic Pain
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.
Treatment of Neuropathic Pain
  • S. Schug
  • Medicine
    Mechanisms of Vascular Disease
  • 2020
Neuropathic pain is caused by a disease or lesion of the somatosensory system and is often underdiagnosed and undertreated, although it can lead to chronic pain states.
Anxiety enhances pain in a model of osteoarthritis and is associated with altered endogenous opioid function and reduced opioid analgesia
Chronic pain states such as osteoarthritis (OA) are often associated with negative affect, including anxiety and depression. This is, in turn, associated with greater opioid analgesic use,
The possibilities of using xenon therapy in patients with severe cancer pain
A successful clinical case is demonstrated when xenon and oxygen inhalations course is used for the treatment of a severe cancer pain with a patient who had been taking morphine by mouth.
Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder
Rotation to BuNa in patients with CNCP and OUD was accompanied by reductions in opioid misuse, opioid craving, the severity of co-occurring psychiatric symptoms, and self-reported pain, which underline the need for the replication of the current findings in large-scale, controlled studies.
Undiscovered morphine. The effects of the long-term use of the opioids
  • Z. Żylicz
  • Medicine, Biology
    Palliative Medicine in Practice
  • 2019
There are suggestions that morphine and other opioids are changing the large bowel microbiome and none of these adverse effects are mentioned in drug leaflets, which are treatable providing that the diagnose is made accurately and timely.
KCC2 receptor upregulation potentiates antinociceptive effect of GABAAR agonist on remifentanil-induced hyperalgesia
Findings suggested that the RIH was initiated by decreased GABA release, and KCC2 enhancer was proved to potentiate antinociceptive effect of GABAAR agonist in RIH.


A comprehensive review of opioid-induced hyperalgesia.
Clinicians should suspect OIH when opioid treatment's effect seems to wane in the absence of disease progression, particularly if found in the context of unexplained pain reports or diffuse allodynia unassociated with the original pain, and increased levels of pain with increasing dosages.
Opioid induced hyperalgesia: clinical implications for the pain practitioner.
The role of sublingual buprenorphine appears to be an attractive, simple option for the treatment of OIH and is particularly advantageous for a busy interventional pain practice.
Opioid-induced Hyperalgesia: A Qualitative Systematic Review
This review provides a comprehensive summary of basic and clinical research concerning opioid-induced hyperalgesia, suggests a framework for organizing pertinent information, delineates the status quo of knowledge, identifies potential clinical implications, and discusses future research directions.
Does Fentanyl Lead to Opioid-induced Hyperalgesia in Healthy Volunteers?: A Double-blind, Randomized, Crossover Trial
A higher dose of fentanyl increased hyperalgesia from 4.5 to 6.5 h in healthy volunteers while simultaneously decreasing pain scores while simultaneously increasing tolerance and tolerance.
The endogenous opioid system is not involved in modulation of opioid-induced hyperalgesia.
Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects
Weak and strong opioids outperformed placebo for pain and function in all types of CNCP and were significantly superior to naproxen and nortriptyline, and only for pain relief.
The Effect of Repeated Intramuscular Alfentanil Injections on Experimental Pain and Abuse Liability Indices in Healthy Males
Repeated alfentanil exposures over 4 to 5 weeks resulted in within session decreases in cold pain tolerance from baseline but these differences were not substantially different from diphenhydramine controls.
Hyperalgesia in heroin dependent patients and the effects of opioid substitution therapy.
Target-controlled dosing of remifentanil during cardiac surgery reduces postoperative hyperalgesia.
The intraoperative decrease of opioid consumption when comparing the CI versus TCI mode of administration of remifentanil led to less OIH after cardiac surgery.