Page 35 Volume 17 - N.3 - 2009
P. 35
Dor (2009) 17
com opióides, o que carece ainda de evidência. 26. Zhao M, Joo DT. Enhancement of spinal N-methyl-D-aspartate re-
Até à data, não existe evidência de eficácia da ceptor function by remifentanil action at delta-opioid receptors as a
mechanism for acute opioid-induced hyperalgesia or tolerance. An-
utilização do magnésio na dor aguda pós-opera- esthesiology. 2008;109:308-17.
tória, particularmente quando utilizado por via 27. Gu X, Wu X, Liu Y, et al. Tyrosine phosphorylation of the N-Methyl-
endovenosa. Devem-se continuar os estudos so- D-Aspartate receptor 2B subunit in spinal cord contributes to re-
bre a sua utilização, tendo em conta o seu poten- mifentanil-induced postoperative hyperalgesia: the preventive effect
of ketamine. Molecular Pain. 2009;5:76.
cial antinociceptivo, o seu baixo custo e o seu 28. Mitra S. Opioid-induced hyperalgesia: pathophysiology and clinical
perfil de segurança. Os trabalhos realizados com implications. J Opioid Manag. 2008;4(3):123-30.
a amantadina são ainda escassos. O verdadeiro 29. Colvin LA, Fallon MT. Opioid-induced hyperalgesia: a clinical chal-
lenge. Br J Anaesth. 2010;104:125-7.
papel dos antagonistas NMDAr no tratamento e 30. Wilder-Smith OH, Arendt-Nielsen L. Postoperative hyperalgesia: its clini-
na prevenção da dor aguda pós-operatória não cal importance and relevance. Anesthesiology. 2006;104(3):601-7.
está, portanto, definido. São necessários mais 31. De Kock MF, Lavand’homme PM. The clinical role of NMDA receptor
antagonists for the treatment of postoperative pain. Best Pract Res
estudos, com amostras maiores e metodologias Clin Anaesthesiol. 2007;21(1):85-98.
mais estruturadas no sentido de identificar no- 32. Pfenninger EG, Durieux ME, Himmelseher S. Cognitive impairment after
vas evidências, fortalecer as já estabelecidas small-dose ketamine isomers in comparison to equianalgesic racemic
ketamine in human volunteers. Anesthesiology. 2002;96(2):357-66.
(Quadro 1) e esclarecer resultados divergentes. 33. Hocking G, Visser EJ, Schug SA. Ketamine: does life begin at 40?
Pain: Clinical Updates (IASP). 2007;15(3):1-6.
Bibliografia 34. Schmid RL, Sandler AN, Katz J. Use and efficacy of low-dose keta-
mine in the management of acute postoperative pain: a review of
1. Hurley RW, Wu CL. Acute Postoperative Pain. Em: Miller RD, Eriks- current techniques and outcomes. Pain. 1999;82(2):111-25.
son LI, Fleisher LA, et al., eds. Miller‘s anesthesia. 7.a ed. Filadélfia: 35. Bell RF, Dahl JB, Moore RA, et al. Peri-operative ketamine for acute
Churchill Livingston; 2009. post-operative pain: a quantitative and qualitative systematic review
2. Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postop- (Cochrane review). Acta Anaesthesiol Scand. 2005;49(10):1405-28.
erative recovery. Lancet. 2003;362:1921-8. 36. Tucker A, Kim Y, Nadeson R, et al. Investigation of potentiation of
3. Bonnet F, Marret E. Influence of anaesthetic and analgesic tech- analgesic effects of fentanyl by ketamine in humans: a double blind-
niques on outcome after surgery. Br J Anaesth. 2005;95(1):52-8. ed, randomized, placebo controlled crossover study of experimental
4. Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth. pain. BMC Anesthesiol. 2005;5:2-14.
2008;101(1):77-86. 37. Yamauchi M, Asano M, Watanabe M, et al. Continuous low-dose keta-
5. Kehlet H, Jensen TS, Woolf C. Persistent postsurgical pain: risk mine improves the analgesic effects of fentanyl patient-controlled anal-
factors and prevention. Lancet. 2006;367:1618-25. gesia after cervical spine surgery. Anesth Analg. 2008;107:1041-4.
6. Perkins FM, Kehlet H. Chronic pain as an outcome of surgery. A 38. Suzuki M. Role of N-methyl-D-aspartate receptor antagonists in postop-
review of predictive factors. Anesthesiology. 2000;93:1123-33. erative pain management. Curr Opin Anaesthesiol. 2009;22(5):618-22.
7. Petrenko AB, Yamakura T, Baba H, et al. The role of N-methil-d-aspartate 39. Elia N, Tramer MR. Ketamine and postoperative pain - a quantitative
(NMDA) receptor in pain: a review. Anesth Analg. 2003;97:1108-16. systematic review of randomized trials. Pain. 2005;113:61-70.
8. Castro Lopes JM. Fisiopatologia da dor. Em: Compilação I da Bib- 40. Bell RF, Dahl JB, Moore RA, et al. Perioperative ketamine for acute
lioteca da DOR. Permanyer Portugal; 2007. post-operative pain. The Cochrane Database of Systematic Reviews.
9. Sandkuhler J. Understanding LTP in pain pathways. Mol Pain. 2006;3:1-61.
2007;3:9. 41. Subramaniam K, Subramaniam B, Steinbrook RA. Ketamine as Ad-
10. Herrero JF, Laird JMA, Lopez-Garcia JA. Wind-up of spinal cord juvant Analgesic to Opioids: A Quantitative and Qualitative System-
neurones and pain sensation: much ado about something? Prog atic Review. Anesth Analg. 2004;99:482-95.
Neurobiol. 2000;61:169-203. 42. Zakine J, Samarcq D, Lorne E, et al. Postoperative ketamine admin-
11. Cervero F. Spinal cord hyperexcitability and its role in pain and hy- istration decreases morphine consumption in major abdominal sur-
peralgesia. Exp Brain Res. 2009;196:129-37. gery: a prospective, randomized, double-blind, controlled study.
12. Sandkuhler J. Models and Mechanisms of Hyperalgesia and Allody- Anesth Analg. 2008;106:1856-61.
nia. Physiol Rev. 2009;89:707-58. 43. Webb AR, Skinner BS, Leong S, et al. The addition of a small-dose
13. Angst MS, Clark JD. Opioid-induced Hyperalgesia A Qualitative ketamine infusion to taramadole for postoperative analgesia: a dou-
Systematic Review. Anesthesiology. 2006;104:570-87. ble-blinded placebo controlled, randomized trial after abdominal
14. Mao J. Opioid-induced hyperalgesia. Pain: Clinical Updates (IASP). surgery. Anesth Analg. 2007;104:912-7.
2008;16(2):1-4. 44. McCartney C, Sinha A, Kates J. A qualitative systematic review of
15. Mao J. Opioid-induced abnormal pain sensitivity: Implications in the role of N-Methyl-D aspartate receptor antagonists in preventive
clinical opioid therapy. Pain. 2002;100:213-7. analgesia. Anesth Analg. 2004;98:1385-400.
16. Guignard B, Bossard AE, Coste C, et al. Acute opioid tolerance: 45. Macintyre PE, Schug SA, Scott DA, et al; APM:SE Working Group of
Intraoperative remifentanil increases postoperative pain and mor- the Australian and New Zealand College of Anaesthetists and Fac-
phine requirement. Anesthesiology. 2000;93:409-17. ulty of Pain Medicine. Acute Pain Management: Scientific Evidence.
17. Chia YY, Liu K, Wang JJ, et al. Intraoperative high dose fentanyl induces 3.a ed. Melbourne: ANZCA & FPM; 2010.
postoperative fentanyl tolerance. Can J Anaesth. 1999;46:872-7. 46. Ong KS, Lirk P, Seymour RA. The efficacy of preemptive analgesia
18. Crawford MW, Hickey C, Zaarour C, et al. Development of acute for acute postoperative pain management: a meta-analysis. Anesth
opioid tolerance during infusion of remifentanil for pediatric scoliosis Analg. 2005;100:757-73.
surgery. Anesth Analg. 2006;102:1662-7. 47. Dahl JB, Moiniche S. Pre-emptive analgesia. Br Med Bull.
19. Joly V, Richebe P, Guignard B, et al. Remifentanil-induced postop- 2004;71:13-27.
erative hyperalgesia and its prevention with small-dose ketamine. 48. Pogatzki-Zahn EM, Zahn PK. From preemptive to preventive analge-
Anesthesiology. 2005;103:147-55. sia. Curr Opin Anaesthesiol. 2006;19(5):551-5.
20. Xuerong Y, Yuguang H, Xia J, et al. Ketamine and lornoxicam for 49. Himmelseher S, Durieux ME. Ketamine for perioperative pain man-
preventing a fentanyl-induced increase in postoperative morphine agement. Anesthesiology. 2005;102:211-20.
requirement. Anesth Analg. 2008;107:2032-7. 50. Berti M, Baciarello M, Troglio R. Clinical uses of low-dose keta-
21. Angst M, Kopper W, Pahl I, et al. Short-term infusion of the mu- mine in patients undergoing surgery. Curr Drug Targets.
opioid agonist remifentanil in humans causes hyperalgesia during 2009;10(8):707-15.
withdrawal. Pain. 2003;106:49-57. 51. Carstensen M, Møller AM. Adding ketamine to morphine for intrave-
22. Mitra S, Sinatra R. Perioperative management of acute pain in the nous patient-controlled analgesia for acute postoperative pain: a
opioid dependent Patient. Anesthesiology. 2004;101:212-27. qualitative review of randomized trials. Br J Anaesth. 2010;104(4):
23. Silverman S. Opioid induced hyperalgesia: clinical implications for 401-6.
the pain practitioner. Pain Physician. 2009;12:679-84. 52. Sveticic G, Gentillini A, Eichenbruger U, et al. Combinations of
24. Koppert W, Schmelz M. The impact of opioid-induced hyperalge- morphine with ketamine for patient controlled analgesia. Anesthesi-
DOR sia for postoperative pain. Best Pract Res Clin Anesthesiol. 2007; 53. Sveticic G, Eichenburger U, Curatolo M. Safety of mixture of mor-
ology. 2003;98:1195-205.
21:65-83.
34 25. Joo DT. Mechanisms of opioid tolerance. merging evidence and phine with ketamine for postoperative patient-controlled analgesia:
an audit with 1026 patients. Acta Anaesthesiol Scand. 2005;49:870-5.
therapeutic implications. Can J Anaesth. 2007;54(12):969-76.

