瑞芬太尼引起的痛觉过敏

Hyperalgesia induced by Remifentanil

大剂量应用阿片类药物可引起阿片类药物诱导的痛觉过敏（opioid-induced hyperalge-sia，OIH），即一种以痛阈降低和对正常疼痛刺激的超敏反应为特点的感觉异常现象。近年有越来越多有关其机制的研究，多集中于中枢谷氨酰胺系统、脊髓强啡呔和下行痛觉易化系统等方面。笔者就 OIH 的发生机制、可引起 OIH 的瑞芬太尼的剂量及预防等方面进行综述。

The use of opioids is proved to be associated with opioid-induced hyperalgesia(OIH), which is defined as an abnormal sense of pain characterized by a decrease in pain threshold and hypersensi-tivity to normal stimulus.There is an increasing number of studies based on the mechanisms,mainly about central glutaminergic system,spinal dynorphins and descending facilitation.The article summarized the mechanisms of OIH,suggested dose of remifentanil inducing OIH as well as major protective measures.