Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
October-2016 Volume 12 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
October-2016 Volume 12 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial

  • Authors:
    • Zenggui Yu
    • Weilan Wu
    • Xiaodan Wu
    • Hongyi Lei
    • Cansheng Gong
    • Shiyuan Xu
  • View Affiliations / Copyright

    Affiliations: Department of Anesthesiology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China, Department of Anesthesiology, Fujian Provincial Hospital, Fuzhou, Fujian 350001, P.R. China
    Copyright: © Yu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 2622-2628
    |
    Published online on: September 8, 2016
       https://doi.org/10.3892/etm.2016.3687
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

High dosages of intra‑operative remifentanil are associated with opioid‑induced hyperalgesia (OIH). The aim of the present study was to investigate the effect of combined dexmedetomidine and flurbiprofen axetil treatment on remifentanil‑induced hyperalgesia. Patients with an American Society of Anesthesiologists physical status of I‑II who were diagnosed with hysteromyoma and scheduled for laparoscopic assisted vaginal hysterectomy (LAVH) were randomly divided into three groups. Group hyperalgesia (Group H, n=29) received intra‑operative remifentanil, Group hyperalgesia and dexmedetomidine (Group HD, n=28) received remifentanil and a continuous infusion of dexmedetomidine, and Group hyperalgesia, dexmedetomidine and flurbiprofen axetil (Group HDF, n=29) received remifentanil, flurbiprofen axetil and dexmedetomidine. Mechanical pain thresholds were measured during the preoperative visit and postoperatively at 1, 6 and 24‑h time points. Visual analog scale (VAS) scores, time to analgesic requirement, total sufentanil consumption and side effects were assessed postoperatively. Mechanical pain threshold at the incision site was significantly lower in Group H compared with Groups HD and HDF (both P<0.05), and significantly higher in Group HDF than in Group HD (P<0.05). The area of secondary hyperalgesia at the incision site was greater in Group H than in the other two groups (both P<0.05), and significantly smaller in Group HDF compared with Group HD (P<0.05). VAS scores and total sufentanil consumption were significantly higher in Group H compared with the other two groups (both P<0.05), and were significantly lower in Group HDF compared with Group HD (P<0.05). Dexmedetomidine combined with flurbiprofen axetil exhibits synergetic effects in the prevention of remifentanil‑induced hyperalgesia in patients undergoing LAVH.
View Figures

Figure 1

Figure 2

Figure 3

View References

1 

Wu CL and Raja SN: Treatment of acute postoperative pain. Lancet. 377:2215–2225. 2011. View Article : Google Scholar : PubMed/NCBI

2 

Angst MS and Clark JD: Opioid-induced hyperalgesia: A qualitative systematic review. Anesthesiology. 104:570–587. 2006. View Article : Google Scholar : PubMed/NCBI

3 

Fletcher D and Martinez V: Opioid-induced hyperalgesia in patients after surgery: A systematic review and a meta-analysis. Br J Anaesth. 112:991–1004. 2014. View Article : Google Scholar : PubMed/NCBI

4 

Lee M, Silverman SM, Hansen H, Patel VB and Manchikanti L: A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 14:145–161. 2011.PubMed/NCBI

5 

Zhao M and Joo DT: Enhancement of spinal N-methyl-D-aspartate receptor function by remifentanil action at delta-opioid receptors as a mechanism for acute opioid-induced hyperalgesia or tolerance. Anesthesiology. 109:308–317. 2008. View Article : Google Scholar : PubMed/NCBI

6 

Chu LF, Angst MS and Clark D: Opioid-induced hyperalgesia in humans: Molecular mechanisms and clinical considerations. Clin J Pain. 24:479–496. 2008. View Article : Google Scholar : PubMed/NCBI

7 

Zheng Y, Cui S, Liu Y, Zhang J, Zhang W, Zhang J, Gu X and Ma Z: Dexmedetomidine prevents remifentanil-induced postoperative hyperalgesia and decreases spinal tyrosine phosphorylation of N-methyl-d-aspartate receptor 2B subunit. Brain Res Bull. 87:427–431. 2012. View Article : Google Scholar : PubMed/NCBI

8 

Tröster A, Sittl R, Singler B, Schmelz M, Schüttler J and Koppert W: Modulation of remifentanil-induced analgesia and postinfusion hyperalgesia by parecoxib in humans. Anesthesiology. 105:1016–1023. 2006. View Article : Google Scholar : PubMed/NCBI

9 

O'Rielly DD and Loomis CW: Increased expression of cyclooxygenase and nitric oxide isoforms, and exaggerated sensitivity to prostaglandin E2, in the rat lumbar spinal cord 3 days after L5-L6 spinal nerve ligation. Anesthesiology. 104:328–337. 2006. View Article : Google Scholar : PubMed/NCBI

10 

Ahmadi S, Muth-Selbach U, Lauterbach A, Lipfert P, Neuhuber WL and Zeilhofer HU: Facilitation of spinal NMDA receptor currents by spillover of synaptically released glycine. Science. 300:2094–2097. 2003. View Article : Google Scholar : PubMed/NCBI

11 

Joly V, Richebe P, Guignard B, Fletcher D, Maurette P, Sessler DI and Chauvin M: Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine. Anesthesiology. 103:147–155. 2005. View Article : Google Scholar : PubMed/NCBI

12 

Blaudszun G, Lysakowski C, Elia N and Tramèr MR: Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: Systematic review and meta-analysis of randomized controlled trials. Anesthesiology. 116:1312–1322. 2012. View Article : Google Scholar : PubMed/NCBI

13 

Gu X, Wu X, Liu Y, Cui S and Ma Z: Tyrosine phosphorylation of the N-Methyl-D-Aspartate receptor 2B subunit in spinal cord contributes to remifentanil-induced postoperative hyperalgesia: The preventive effect of ketamine. Mol Pain. 5:762009. View Article : Google Scholar : PubMed/NCBI

14 

Faber ES, Chambers JP and Evans RH: Depression of NMDA receptor-mediated synaptic transmission by four alpha2 adrenoceptor agonists on the in vitro rat spinal cord preparation. Br J Pharmacol. 124:507–512. 1998. View Article : Google Scholar : PubMed/NCBI

15 

Kimura M, Saito S and Obata H: Dexmedetomidine decreases hyperalgesia in neuropathic pain by increasing acetylcholine in the spinal cord. Neurosci Lett. 529:70–74. 2012. View Article : Google Scholar : PubMed/NCBI

16 

Xu B, Zhang WS, Yang JL, Lû N, Deng XM, Xu H and Zhang YQ: Evidence for suppression of spinal glial activation by dexmedetomidine in a rat model of monoarthritis. Clin Exp Pharmacol Physiol. 37:e158–e166. 2010. View Article : Google Scholar : PubMed/NCBI

17 

Liu L, Ji F, Liang J, He H, Fu Y and Cao M: Inhibition by dexmedetomidine of the activation of spinal dorsal horn glias and the intracellular ERK signaling pathway induced by nerve injury. Brain Res. 1427:1–9. 2012. View Article : Google Scholar : PubMed/NCBI

18 

Lee C, Kim YD and Kim JN: Antihyperalgesic effects of dexmedetomidine on high-dose remifentanil-induced hyperalgesia. Korean J Anesthesiol. 64:301–307. 2013. View Article : Google Scholar : PubMed/NCBI

19 

Singler B, Tröster A, Manering N, Schüttler J and Koppert W: Modulation of remifentanil induced postinfusion hyperalgesia by propofol. Anesth Analg. 104:1397–1403. 2007. View Article : Google Scholar : PubMed/NCBI

20 

Ohmukai O: Lipo-NSAID preparation. Adv Drug Deliv Rev. 20:203–207. 1996. View Article : Google Scholar

21 

Baba H, Kohno T, Moore KA and Woolf CJ: Direct activation of rat spinal dorsal horn neurons by prostaglandin E2. J Neurosci. 21:1750–1756. 2001.PubMed/NCBI

22 

Wen ZH, Chang YC, Cherng CH, Wang JJ, Tao PL and Wong CS: Increasing of intrathecal CST excitatory amino acids concentration following morphine challenge in morphine-tolerant rats. Brain Res. 995:253–259. 2004. View Article : Google Scholar : PubMed/NCBI

23 

Li SQ, Xing YL, Chen WN, Yue SL, Li L and Li WB: Activation of NMDA receptor is associated with up-regulation of COX-2 expression in the spinal dorsal horn during nociceptive inputs in rats. Neurochem Res. 34:1451–1463. 2009. View Article : Google Scholar : PubMed/NCBI

24 

Lenz H, Raeder J, Draegni T, Heyerdahl F, Schmelz M and Stubhaug A: Effects of COX inhibition on experimental pain and hyperalgesia during and after remifentanil infusion in humans. Pain. 152:1289–1297. 2011. View Article : Google Scholar : PubMed/NCBI

25 

Akbari E: The role of cyclo-oxygenase inhibitors in attenuating opioid-induced tolerance, hyperalgesia, and dependence. Med Hypotheses. 78:102–106. 2012. View Article : Google Scholar : PubMed/NCBI

26 

Koppert W, Wehrfritz A, Körber N, Sittl R, Albrecht S, Schüttler J and Schmelz M: The cyclooxygenase isozyme inhibitors parecoxib and paracetamol reduce central hyperalgesia in humans. Pain. 108:148–153. 2004. View Article : Google Scholar : PubMed/NCBI

27 

Tröster A, Sittl R, Singler B, Schmelz M, Schüttler J and Koppert W: Modulation of remifentanil-induced analgesia and postinfusion hyperalgesia by parecoxib in humans. Anesthesiology. 105:1016–1023. 2006. View Article : Google Scholar : PubMed/NCBI

28 

Hinrichs-Rocker A, Schulz K, Järvinen I, Lefering R, Simanski C and Neugebauer EA: Psychosocial predictors and correlates for chronic post-surgical pain (CPSP)-a systematic review. Eur J Pain. 13:719–730. 2009. View Article : Google Scholar : PubMed/NCBI

29 

Rolke R, Baron R, Maier C, Tölle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Bötefür IC, et al: Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol and reference values. Pain. 123:231–243. 2006. View Article : Google Scholar : PubMed/NCBI

30 

Lee C, Lee HW and Kim JN: Effect of oral pregabalin on opioid-induced hyperalgesia in patients undergoing laparo-endoscopic single-site urologic surgery. Korean J Anesthesiol. 64:19–24. 2013. View Article : Google Scholar : PubMed/NCBI

31 

Tena B, Escobar B, Arguis MJ, Cantero C, Rios J and Gomar C: Reproducibility of Electronic Von Frey and Von Frey monofilaments testing. Clin J Pain. 28:318–323. 2012. View Article : Google Scholar : PubMed/NCBI

32 

Bajwa SJ, Gupta S, Kaur J, Singh A and Parmar S: Reduction in the incidence of shivering with perioperative dexmedetomidine: A randomized prospective study. J Anaesthesiol Clin Pharmacol. 28:86–91. 2012. View Article : Google Scholar : PubMed/NCBI

33 

Elmawgood AA, Rashwan S and Rashwan D: Effect of parecoxib on remifentanil induced postoperative shivering. Egypt J Anaesthesiol. 30:399–403. 2014. View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Yu Z, Wu W, Wu X, Lei H, Gong C and Xu S: Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial. Exp Ther Med 12: 2622-2628, 2016.
APA
Yu, Z., Wu, W., Wu, X., Lei, H., Gong, C., & Xu, S. (2016). Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial. Experimental and Therapeutic Medicine, 12, 2622-2628. https://doi.org/10.3892/etm.2016.3687
MLA
Yu, Z., Wu, W., Wu, X., Lei, H., Gong, C., Xu, S."Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial". Experimental and Therapeutic Medicine 12.4 (2016): 2622-2628.
Chicago
Yu, Z., Wu, W., Wu, X., Lei, H., Gong, C., Xu, S."Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial". Experimental and Therapeutic Medicine 12, no. 4 (2016): 2622-2628. https://doi.org/10.3892/etm.2016.3687
Copy and paste a formatted citation
x
Spandidos Publications style
Yu Z, Wu W, Wu X, Lei H, Gong C and Xu S: Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial. Exp Ther Med 12: 2622-2628, 2016.
APA
Yu, Z., Wu, W., Wu, X., Lei, H., Gong, C., & Xu, S. (2016). Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial. Experimental and Therapeutic Medicine, 12, 2622-2628. https://doi.org/10.3892/etm.2016.3687
MLA
Yu, Z., Wu, W., Wu, X., Lei, H., Gong, C., Xu, S."Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial". Experimental and Therapeutic Medicine 12.4 (2016): 2622-2628.
Chicago
Yu, Z., Wu, W., Wu, X., Lei, H., Gong, C., Xu, S."Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: A randomized controlled trial". Experimental and Therapeutic Medicine 12, no. 4 (2016): 2622-2628. https://doi.org/10.3892/etm.2016.3687
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team