瑞芬太尼
痛觉过敏
强啡肽
医学
麻醉
类阿片
药理学
氯胺酮
异丙酚
伤害
内科学
受体
阿片肽
作者
Alexander A. Vitin,Talmage D. Egan
出处
期刊:Current Opinion in Anesthesiology
[Ovid Technologies (Wolters Kluwer)]
日期:2024-06-04
标识
DOI:10.1097/aco.0000000000001400
摘要
Remifentanil-induced hyperalgesia (RIH) is a part of a general opioid-induced hyperalgesia (OIH) syndrome, seemingly resulting from abrupt cessation of continuous remifentanil infusion at rates equal or exceeding 0.3 mcg/kg/min. The intricate mechanisms of its development are still not completely understood. However, hyperactivation of the N -methyl d -aspartate receptor system, descending spinal facilitation and increased concentration of dynorphin (a κ-opioid ligand) are commonly proposed as possible mechanisms. Several ways of prevention and management have been suggested, such as slow withdrawal of remifentanil infusion, the addition of propofol, pretreatment with or concomitant administration of ketamine, buprenorphine, cyclooxygenase-2 inhibitors (NSAIDs), methadone, dexmedetomidine. In clinical and animal studies, these strategies exhibited varying success, and many are still being investigated.
科研通智能强力驱动
Strongly Powered by AbleSci AI