Early detection of opioid-induced hyperalgesia after an ICU stay using quantified sensory testing: An observational cohort case-control study.

IF 1.3 Q4 CLINICAL NEUROLOGY

British Journal of Pain Pub Date : 2025-06-30 DOI:10.1177/20494637251356830

Paul Tarpin, Eric Serra, Yazine Mahjoub, Valéria Martinez

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引用次数: 0

Abstract

Background: Opioids can heighten sensitivity to noxious stimuli, leading to opioid-induced hyperalgesia (OIH). Despite the frequent use of high opioid doses in ICU settings, the presence of OIH following ICU stays remains undocumented.

Methods: This prospective observational study aimed to assess OIH presence and its clinical implications in post-ICU patients. Adults with confirmed Sars-CoV-2 infection hospitalized in the ICU for over 48 h were included, with opioid dosage recorded. At ICU discharge, 11 quantitative sensory tests (QSTs) were conducted at two non-painful sites, and pain presence, intensity, and characteristics were assessed at discharge and 4 months later.

Results: Analysis of 41 patients (20 opioid-treated, 21 controls) revealed significantly higher hyperalgesia levels in the opioid-treated group across six tests at both sites, including cold pain thresholds, heat and cold tolerance thresholds, duration of tolerance to a 47°C stimulus, and thermal and mechanical temporal summation.

Conclusions: Our findings underscore the importance of QST in early OIH detection, identifying thermal tolerance thresholds and thermal/mechanical temporal summation tests as sensitive indicators. Subclinical hyperalgesia in ICU patients on opioids heightens susceptibility to chronic pain development, emphasizing the need for vigilant opioid monitoring and adjustment in ICU care.

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使用量化感觉测试在ICU住院后早期检测阿片类药物引起的痛觉过敏：一项观察性队列病例对照研究。

背景：阿片类药物可以提高对有害刺激的敏感性，导致阿片类药物诱导的痛觉过敏（OIH）。尽管在ICU环境中经常使用高剂量阿片类药物，但ICU住院后OIH的存在仍然没有记录。方法：本前瞻性观察性研究旨在评估icu后患者OIH的存在及其临床意义。纳入在ICU住院超过48小时的确诊Sars-CoV-2感染的成年人，并记录阿片类药物剂量。出院时，在两个非疼痛部位进行11次定量感觉测试（QSTs），并在出院时和4个月后评估疼痛的存在、强度和特征。结果：对41名患者（20名阿片类药物治疗组，21名对照组）的分析显示，在两个部位的6项测试中，阿片类药物治疗组的痛觉过敏水平明显更高，包括冷痛阈值、热和冷耐受性阈值、对47°C刺激的耐受性持续时间，以及热和机械时间之和。结论：我们的研究结果强调了QST在OIH早期检测中的重要性，确定了热容阈值和热/力学时间总和试验作为敏感指标。服用阿片类药物的ICU患者的亚临床痛觉过敏增加了对慢性疼痛发展的易感性，强调了在ICU护理中警惕阿片类药物监测和调整的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British Journal of Pain CLINICAL NEUROLOGY-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.