Article: Remifentanil-Induced Secondary Hyperalgesia Is Not Prevented By Preoperative Acetazolamide Administration In Patients Undergoing Total Thyroidectomy: A Randomized Controlled Trial.
2019 Volume 12, Page(s) 2991–2997
Abstract: Purpose: Acute administration of remifentanil may lead to opioid-induced hyperalgesia (OIH). Studies in mice suggest that OIH is mediated by impaired anionic homeostasis in spinal lamina I neurons due to a down-regulation of the K: Patients and ... ...
| Abstract | Purpose: Acute administration of remifentanil may lead to opioid-induced hyperalgesia (OIH). Studies in mice suggest that OIH is mediated by impaired anionic homeostasis in spinal lamina I neurons due to a down-regulation of the K Patients and methods: We conducted a randomized, double-blind, placebo-controlled clinical trial between December 2016 and September 2018. Patients were randomly allocated to receive ACTZ (250 mg of ACTZ 2 h before surgery) or placebo. To detect hyperalgesia, mechanical pain threshold (MPT) were measured before and after surgery using hand-held von Frey filaments in the forearm. Anesthesia was maintained with remifentanil at a target effect site of 4.5 ± 0.5 ng/mL, and sevoflurane at an end-tidal concentration of 0.8 MAC corrected for age. Results: In total, 47 patients completed the study. Both groups were comparable in the baseline characteristics and intraoperative variables. Baseline MPT were similar in both groups. However, MPT in the forearm significantly diminished in the time in both groups. Finally, postoperative pain and morphine consumption were similar between groups. Conclusion: Both groups developed remifentanil-mediated OIH at 12-18 h after surgery. However, ACTZ did not prevent the MPT reduction in patients undergoing total thyroidectomy. |
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| Language | English |
| Publishing date | 2019-11-06 |
| Publishing country | New Zealand |
| Document type | Journal Article |
| ZDB-ID | 2495284-9 |
| ISSN | 1178-7090 |
| ISSN | 1178-7090 |
| DOI | 10.2147/JPR.S221131 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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