Methods for the assessment of opioid-induced hyperalgesia in the perioperative period

BACKGROUND AND OBJECTIVES:Opioid-induced hyperalgesia is a topic not yet fully understood in terms of mechanisms, diagnosis, prevention and treatment. Thus, it seems of great importance to evaluate this phenomenon that negatively affects the treatment of pain. The purpose of this study was to describe what tools to use to evaluate perioperative hyperalgesia.CONTENTS:Several methods have been suggested to evaluate opioid-induced hyperalgesia, such as measure of pain intensity, opioid consumption, and evaluation of secondary hyperalgesia with algometer and Von Frey monofilaments. The measurement of some substances, such as cytokines, glutamate, and dynorphin has also been used.CONCLUSION:There are several ways to evaluate opioidinduced hiperalgesia, easily reproducible tests should be chosen and which have also been described in previous studies.

背景与目的：阿片类药物诱导的痛觉过敏（Opioid-induced hyperalgesia）在机制、诊断、预防与治疗方面尚未被完全阐明。该现象会对疼痛治疗产生负面影响，因此对其开展相关评估具有重要意义。本研究旨在明确可用于评估围手术期痛觉过敏的工具类型。
研究内容：目前已提出多种评估阿片类药物诱导的痛觉过敏的方法，包括疼痛强度量化、阿片类药物消耗量测定，以及使用痛觉计（algometer）与冯·弗雷单丝（Von Frey monofilaments）评估继发性痛觉过敏。此外，细胞因子（cytokines）、谷氨酸（glutamate）、强啡肽（dynorphin）等物质的含量检测也被应用于该类评估。
结论：目前存在多种评估阿片类药物诱导的痛觉过敏的方案，应选择易于重复且已在既往研究中得到验证的检测方法。