Opioid-Induced Hyperalgesia After Surgery: Clinical Relevance

  • Philippe RichebeEmail author
  • Cyrip Rivat


For decades opioids have been used to treat chronic pain as well as perioperative pain. More recently, the phenomenon of opioid-induced hyperalgesia (OIH) was introduced in the literature: the demonstration of diffuse hyperalgesia after chronic exposure to morphine (or other opioids), OIH, was linked to evidence of central sensitization detected by changes in heat tolerance thresholds and temporal summation tests (Chu et al., J Pain 7(1):43–8, 2006; Compton et al., Drug Alcohol Depend 63(2):139–46, 2001; Chen et al., Pain 143(1–2):65–70, 2009; Woolf, Pain 152(3 Suppl.):S2–15, 2011). To date, preexisting OIH, in the perioperative period, has not been well reported in the anesthesia literature. However, experimental studies suggest that sensitivity to pain is greater in those animals who have been exposed to opioids perioperatively as compared to those who were unexposed animals (Laboureyras et al., Anesth Analg 109(2):623–31, 2009; Celerier et al., Anesthesiology 92(2):465–72, 2000; Rivat et al., Anesthesiology 96(2):381–91, 2002).


Acute pain/physiopathology Analgesics, opioid/administration, and dosage Chronic pain/drug therapy Chronic pain/epidemiology Chronic pain/physiopathology Hyperalgesia/drug therapy Hyperalgesia/epidemiology Hyperalgesia/physiopathology Morphine/administration and dosage Pain, postoperative/drug therapy Pain, postoperative/epidemiology Pain, postoperative/physiopathology Remifentanil 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Maisonneuve Rosemont Hospital, CIUSSS de l’Est-de-l’ile-de-MontrealMontrealCanada
  2. 2.Department of AnesthesiologyUniversity of MontrealMontrealCanada

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