REVISTA

La naloxona bloquea la hiperalgesia inducida por remifentanilo

Valoración Valoración: 5 Estrellas

Descripción: Dosis muy bajas de naloxona bloquean la hiperalgesia pero no impide la tolerancia a los opioides

TITULO FUENTE ORIGINAL:

Effects of naloxone on opioid induced hyperalgesia and tolerance to remifentanil under sevoflurane anesthesia in rats

AUTORES:

Aguado D, Abreu M, Benito J, Garcia-Fernandez J, Gómez de Segura IA

REVISTA ABREV.:

Anesthesiology

AÑO:

2013

REFERENCIA:

118(5):1160-9

DOI:

10.1097/ALN.0b013e3182887526

RESUMEN ORIGINAL:

BACKGROUND:Opioid antagonists at ultra-low doses have been used with opioid agonists to prevent or limit opioid tolerance. The aim of this study was to evaluate whether an ultra-low dose of naloxone combined with remifentanil could block opioid-induced hyperalgesia and tolerance under sevoflurane anesthesia in rats.
METHODS:Male adult Wistar rats were allocated into one of four treatment...
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BACKGROUND:Opioid antagonists at ultra-low doses have been used with opioid agonists to prevent or limit opioid tolerance. The aim of this study was to evaluate whether an ultra-low dose of naloxone combined with remifentanil could block opioid-induced hyperalgesia and tolerance under sevoflurane anesthesia in rats.
METHODS:Male adult Wistar rats were allocated into one of four treatment groups (n = 7), receiving remifentanil (4 µg·kg·min) combined with naloxone (0.17 ng·kg·min), remifentanil alone, naloxone alone, or saline. Animals were evaluated for mechanical nociceptive thresholds (von Frey) and subsequently anesthetized with sevoflurane to determine the baseline minimum alveolar concentration (MAC). Next, treatments were administered, and the MAC was redetermined twice during the infusion. The experiment was performed three times on nonconsecutive days (0, 2, and 4). Hyperalgesia was considered to be a decrease in mechanical thresholds, whereas opioid tolerance was considered to be a decrease in sevoflurane MAC reduction by remifentanil.
RESULTS:Remifentanil produced a significant decrease in mechanical thresholds compared with baseline values at days 2 and 4 (mean ± SD, 30.7 ± 5.5, 22.1 ± 6.4, and 20.7 ± 3.7g at days 0, 2, and 4, respectively) and an increase in MAC baseline values (2.5 ± 0.3, 3.0 ± 0.3, and 3.1 ± 0.3 vol% at days 0, 2, and 4, respectively). Both effects were blocked by naloxone coadministration. However, both remifentanil-treated groups (with or without naloxone) developed opioid tolerance determined by their decrease in MAC reduction.
CONCLUSIONS:An ultra-low dose of naloxone blocked remifentanil-induced hyperalgesia but did not change opioid tolerance under inhalant anesthesia. Moreover, the MAC increase associated with hyperalgesia was also blocked by naloxone.

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DOCUMENTACIÓN

Artículo en pdf: naloxona-en-hiperalgesia-y-tolerancia-opioide[...]


ENLACES DE INTERÉS

Enlace revista:: http://anesthesiology.pubs.asahq.org/article.[...]