Related Experiment Video
Updated: Jun 24, 2025

Determining heat and mechanical pain threshold in inflamed skin of human subjects
Published on: January 14, 2009
Remifentanil-induced hyperalgesia: the current state of affairs
Alexander A Vitin1, Talmage D Egan2
1Department of Anesthesiology, Perioperative & Pain Medicine.
None:
Remifentanil-induced hyperalgesia (RIH) is a part of a general opioid-induced hyperalgesia (OIH) syndrome, seemingly resulting from abrupt cessation of continuous remifentanil infusion at rates equal or exceeding 0.3 mcg/kg/min. The intricate mechanisms of its development are still not completely understood. However, hyperactivation of the N -methyl d -aspartate receptor system, descending spinal facilitation and increased concentration of dynorphin (a κ-opioid ligand) are commonly proposed as possible mechanisms. Several ways of prevention and management have been suggested, such as slow withdrawal of remifentanil infusion, the addition of propofol, pretreatment with or concomitant administration of ketamine, buprenorphine, cyclooxygenase-2 inhibitors (NSAIDs), methadone, dexmedetomidine. In clinical and animal studies, these strategies exhibited varying success, and many are still being investigated.
More Related Videos
Related Concept Videos
Analgesia and Pain Management
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Parenteral Anesthetics: Overview
Nociception
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

