Medycyna Paliatywna

Abstract

3/2013 vol. 5
Review paper

Opioid-induced hyperalgesia a practical problem in the treatment of pain in patients with a cancer

Medycyna Paliatywna 2013; 5(3): 88–92
Online publish date: 2013/11/08
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A complication of the opioid-based treatment of pain in patients with a cancer could be opioid-induced hyperalgesia. This phenomenon is paradoxical occurrence of pain or exacerbation of pain during the use of opioid analgetics. Opioid-induced hyperalgesia is associated with changes in the conformation of the opioid receptors. In this paper based on the literature presens 6 mechanisms of this phenomenon. These are: stimulation of NMDA receptors, opioid receptors desensitization, the effect of dynorphin A, descending impulse control pain associated with activation of On-Off cells, increasing the level of cAMP and genetic changes involving the substitution of methionine by valine affecting neurotransmission of dopamine/norepinephrine. In the following section describes the proposed method of treatment of opioid-induced hyperalgesia.
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