Abstract
The Dilemma of Opioid-Induced Hyperalgesia and Tolerance in Chronic Opioid Therapy = معضلة فرط التألم و حالة التحمل الناتج عن العلاج طويل الأمد بالأدوية ( المسكنات ) الأفيونية
Highlights
Sir, Opioids have been used for decades and continue to be used to treat severe, acute, chronic non-cancer and cancer pain.[1,2] They work mainly by inhibiting spinal cord neuronal transduction and the ascending pain signals at midbrain nuclei, and through the modulation of limbic system pain perception.[3]
When we escalate the opioid dose without getting the expected clinical response, we may face the dilemma of tolerance, which can be defined as a decrease in pharmacologic response following repeated or prolonged drug administration
In the case of opioids, patients may experience opioid-induced hyperalgesia (OIH), which is a state of nociceptive sensitisation caused by exposure to opioids that leads to an increased response to a stimulus which is normally painful.[1,2,3,4]
Summary
Opioids have been used for decades and continue to be used to treat severe, acute, chronic non-cancer and cancer pain.[1,2] They work mainly by inhibiting spinal cord neuronal transduction and the ascending pain signals at midbrain nuclei, and through the modulation of limbic system pain perception.[3].
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