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Controlled Clinical Trial
. 2009 May;143(1-2):65-70.
doi: 10.1016/j.pain.2009.01.022. Epub 2009 Feb 23.

Altered quantitative sensory testing outcome in subjects with opioid therapy

Lucy Chen  1 , Charlene Malarick, Lindsey Seefeld, Shuxing Wang, Mary Houghton, Jianren Mao
Affiliations
Controlled Clinical Trial

Altered quantitative sensory testing outcome in subjects with opioid therapy

Lucy Chen et al. Pain. 2009 May.

Abstract

Preclinical studies have suggested that opioid exposure may induce a paradoxical decrease in the nociceptive threshold, commonly referred as opioid-induced hyperalgesia (OIH). While OIH may have implications in acute and chronic pain management, its clinical features remain unclear. Using an office-based quantitative sensory testing (QST) method, we compared pain threshold, pain tolerance, and the degree of temporal summation of the second pain in response to thermal stimulation among three groups of subjects: those with neither pain nor opioid therapy (group 1), with chronic pain but without opioid therapy (group 2), and with both chronic pain and opioid therapy (group 3). We also examined the possible correlation between QST responses to thermal stimulation and opioid dose, opioid treatment duration, opioid analgesic type, pain duration, or gender in group 3 subjects. As compared with both group 1 (n=41) and group 2 (n=41) subjects, group 3 subjects (n=58) displayed a decreased heat pain threshold and exacerbated temporal summation of the second pain to thermal stimulation. In contrast, there were no differences in cold or warm sensation among three groups. Among clinical factors, daily opioid dose consistently correlated with the decreased heat pain threshold and exacerbated temporal summation of the second pain in group 3 subjects. These results indicate that decreased heat pain threshold and exacerbated temporal summation of the second pain may be characteristic QST changes in subjects with opioid therapy. The data suggest that QST may be a useful tool in the clinical assessment of OIH.

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Conflict of interest statement

The authors claim no conflict of interest.

Figures

Fig. 1
Fig. 1. Exacerbated temporal summation of the second pain in group 3 subjects
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References

    1. Ali NM. Hyperalgesic response in a patient receiving high concentrations of spinal morphine. Anesthesiology. 1986;65:449. - PubMed
    1. Angst MS, Clark JD. Opioid-induced hyperalgesia: a qualitative systematic review. Anesthesiology. 2006;104:570–587. - PubMed
    1. Angst MS, Koppert W, Pahl I, Clark DJ, Schmelz M. Short-term infusion of the mu-opioid agonist remifentanil in humans causes hyperalgesia during withdrawal. Pain. 2003;106:49–57. - PubMed
    1. Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med. 2003;349:1943–1953. - PubMed
    1. Celerier E, Laulin JP, Corcuff JB, Le Moal M, Simonnet G. Progressive enhancement of delayed hyperalgesia induced by repeated heroin administration: a sensitization process. J Neurosci. 2001;21:4074–4080. - PMC - PubMed

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