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Opioid induced hyperalgesia altered with propofol infusion
Alan D Kaye1, Keun Sam Chung, Nalini Vadivelu
1Department of Anesthesiology, LSU School of Medicine, New Orleans, LA.
Pain Physician
|March 25, 2014
Summary
Propofol may offer relief from opioid-induced hyperalgesia, a condition where pain worsens despite increased opioid doses. This case study suggests Propofol
Area of Science:
- Anesthesiology and Pain Management
- Neuropharmacology
Background:
- Propofol is a widely used anesthetic induction agent.
- Its potential therapeutic roles beyond anesthesia are under investigation.
- Controversy surrounds Propofol's analgesic and antihyperalgesic properties.
Observation:
- A patient experienced poorly controlled pain despite escalating opioid doses, indicative of opioid-induced hyperalgesia.
- The patient's pain was refractory to increasing fentanyl doses.
- A Propofol infusion was administered to manage the patient's condition.
Findings:
- The Propofol infusion successfully managed the patient's opioid-induced hyperalgesia.
- This clinical case suggests Propofol may possess antihyperalgesic effects in patients with chronic opioid use.
- N-Methyl-D-Aspartate (NMDA) receptor inhibition by Propofol is postulated as a mechanism for breaking the hyperalgesia cycle.
Implications:
- Propofol could be a potential therapeutic option for managing opioid-induced hyperalgesia.
- Further clinical research is necessary to confirm Propofol's analgesic and antihyperalgesic effects in humans.
- Understanding Propofol's interaction with NMDA receptors may reveal novel pain management strategies.
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