应用他克莫司后的阿片类药物相关痛觉超敏与快速脱毒  

作　　者：Antonio Siniscalchi, MD Emanuele Piraccini, MD Zuzana Miklosova, MD Stefania Taddei, MD Stefano Faenza, MD, Mph Gerardo Martinelli, MD, Mph 石金山(译) 

机构地区：[1]Department of Anesthesiology, University of Bologna, Bologna, Italy [2]Department of Anesthesiology, S. Orsola-Malpighi Hospital, Bologna, Italy [3]不详

出　　处：《麻醉与镇痛》2009年第2期90-92,共3页Anesthesia & Analgesia

摘　　要：阿片类药物能促使中枢敏化及诱导痛觉超敏，称之为阿片类药物诱导的痛觉超敏（Opioid-Induced Hyperalgesia）。本文报道1例女性患者在接受肠移植手术后发生了与免疫抑制剂相关的神经病理性疼痛。在对其疼痛治疗的3年时间里，我们选择了包括静脉注射吗啡在内的不同镇痛方法，可是收效甚微。该患者产生了阿片类药物诱导的痛觉超敏现象，然而此现象在全身麻醉下通过快速脱毒得以成功治疗。脱毒疗法改善了她的生活质量，包括能够重新接受物理治疗。治疗后6个月，仍无需使用阿片类药物。我们的经验表明，全身麻醉下快速脱毒，可能是治疗阿片类药物诱导的痛觉超敏的一种有效方法，值得和传统的脱毒方法进行比较。Opioids can induce central sensitization and hyperalgesia, referred to as ＂opioid-induced hyperalgesia.＂ Our report describes a patient who underwent intestinal transplant followed by immunosuppressant-related neuropathic pain. Her pain was treated with limited success over the course of 3 yr with different therapies, including Ⅳ morphine. She developed opioid-induced hyperalgesia, which was successfully treated with rapid detoxification under general anesthesia. Detoxificafion improved her quality of life, including the ability to resume physiotherapy. Six months after treatment, she remained optoid free. Our experience suggests that rapid detoxificafion under general anesthesia may be an effective treatment for opioid-induced hyperalgesia and merits comparison to traditional detoxification methods

关 键 词：阿片类药物 痛觉超敏 快速脱毒 他克莫司 神经病理性疼痛 免疫抑制剂相关 物相 药物诱导 

分 类 号：R971.1[医药卫生—药品] R245.97[医药卫生—药学]