Dexmedetomidine Infusion for the Management of Opioid‐Induced Hyperalgesia

Dexmedetomidine Infusion for the Management of Opioid?Induced Hyperalgesia - Belgrade - 2010 - Pain Medicine - Wiley Online LibrarySkip to Main Content

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PUBLICATIONSBROWSE BY SUBJECTRESOURCESABOUT US LOGIN Enter e-mail address Enter password REMEMBER ME NOT REGISTERED ?FORGOTTEN PASSWORD ?INSTITUTIONAL LOGIN > JOURNAL TOOLS Get New Content Alerts Get RSS feed Save to My Profile Get Sample Copy JOURNAL MENU Journal Home FIND ISSUES Current IssueAll IssuesVirtual Issues FIND ARTICLES Early View GET ACCESS Subscribe / Renew FOR CONTRIBUTORS Author GuidelinesSubmit an Article ABOUT THIS JOURNAL Society InformationNewsOverviewEditorial BoardPermissionsAdvertiseContact SPECIAL FEATURES Professional OpportunitiesPainPoints Blog Dexmedetomidine Infusion for the Management of Opioid?Induced HyperalgesiaMiles Belgrade MD, Sara Hall MS, ACNS?BC, RN?BCArticle first published online: 28 OCT 2010

DOI: 10.1111/j.1526-4637.2010.00973.x

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Pain MedicineEarly View (Articles online in advance of print)

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How to CiteBelgrade, M. and Hall, S. , Dexmedetomidine Infusion for the Management of Opioid?Induced Hyperalgesia. Pain Medicine, no. doi: 10.1111/j.1526-4637.2010.00973.x

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Fairview Pain Management Center, University of Minnesota Medical Center, Minneapolis, Minnesota, USA

*Correspondence: Miles Belgrade, MD, 606 24th Ave. S., Suite 600, Minneapolis, MN 55454, USA.? Tel: 612?273?9925; Fax: 612?273?9945;? E?mail: mbelgra1@fairview.org.

Publication HistoryArticle first published online: 28 OCT 2010 SEARCH Search Scope All contentPublication titlesIn this journalIn this issue Search String Advanced >Saved Searches > SEARCH BY CITATION Volume: Issue: Page: ARTICLE TOOLSGet PDF (521K)Save to My ProfileE-mail Link to this ArticleExport Citation for this ArticleRequest Permissions AbstractArticleReferencesCited By View Full Article (HTML) Get PDF (521K) Keywords:Opioid?Induced Hyperalgesia;Dexmedetomidine;Alpha?2 Adrenergic Agonists;Opioid Withdrawal;Opioid ToleranceAbstract

Objective.? Understanding the actions of opioids now encompasses pronociceptive as well as antinociceptive mechanisms. Opioid?induced hyperalgesia (OIH) refers to increased pain sensitivity due to high?dose or prolonged opioid exposure. It has become more important as patients with pain remain on opioids at higher doses for longer periods of time. One setting that highlights the dilemma of OIH is in the opioid?tolerant patient who is hospitalized for painful medical conditions or procedures and is unable to achieve adequate analgesia despite escalating opioid doses. This patient population often requires agents that act synergistically with opioids through different mechanisms to achieve analgesia. Dexmedetomidine is an alpha?2 adrenergic agonist that has been shown to synergize with opioids.

Setting.? Tertiary care hospital.

Design.? Case series.

Method.? Eleven hospitalized patients with OIH received dexmedetomidine to improve pain control and to lower opioid doses while avoiding opioid withdrawal.

Results.? A total of 64% (7/11) had substantial reductions in their baseline opioid doses at the time of discharge.

Conclusions.? The cases presented provide support for the clinical utility of alpha?2 agonists during opioid dose reduction in patients with OIH as well suggesting that they may contribute to the recovery of normal nociceptive and antinociceptive responses.

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