PMID- 33079325
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201023
IS  - 2363-9024 (Electronic)
IS  - 2363-9024 (Linking)
VI  - 6
IP  - 1
DP  - 2020 Oct 20
TI  - Qualitative measurement of opioid effects on pain and dyspnea: gender difference 
      in the sensitivity.
PG  - 85
LID - 10.1186/s40981-020-00391-y [doi]
LID - 85
AB  - BACKGROUND: An increasing number of patients come to the operating room in use of 
      opioid analgesics. They have different levels of tolerance to opioid effects 
      which challenge the anesthesiologists in search of safe and effective opioid 
      dosing perioperatively. The tested hypothesis is that simple measures introduced 
      will allow us to measure tolerance qualitatively. Opioid effects on pain 
      (analgesia) and dyspnea sensations (relieving effect) are tested. Patients were 
      allocated to three groups according to pre-operative analgesics: (1) control, 
      without any opioid analgesics, (2) weak opioid, and (3) strong opioid. Pressure 
      pain threshold (PPT) and no-respiratory sensation period (NRSP) were measured at 
      two points: before and 3 min after intravenous fentanyl administration. RESULTS: 
      A total of 58 (43 controls, 9 weak opioids, and 6 strong opioids) patients were 
      enrolled. PPT and NRSP, after iv 2 mug/kg ideal body weight (IBW) fentanyl, were 
      significantly elevated in the control patients (PPT: 6.2 +/- 2.1 N to 9.2 +/- 3.9 N, 
      p < 0.0001, NRSP: 17.8 +/- 10.8 s to 22.8 +/- 18.7 s, p < 0.005, paired t test). 
      However, preoperative opioid use, though with tendency, did not show a 
      significant decrease of the opioid effect. Due to an insufficient number of 
      participants, no conclusion could be drawn. Further analysis of the data from 
      control patients showed a significant difference between the two sexes in 
      sensitivity to PPT and NRSP, as well as fentanyl effect on PPT. CONCLUSIONS: 
      Current data showed a simple method of measuring the opioid effect on two 
      dimensions: pain and respiration. Though not able to show a qualitative 
      measurement of tolerance formation in opioid-users, data from control patients 
      showed females to be more sensitive to pain and dyspnea but is less sensitive to 
      the opioid effect. Further studies are necessary to show whether these gender 
      differences serve as clinical relevance. TRIAL REGISTRATION: UMIN, UMIN 
      000011580. Registered 27 August 2013, 
      https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000013352&language=J.
FAU - Nozaki-Taguchi, Natsuko
AU  - Nozaki-Taguchi N
AUID- ORCID: 0000-0001-7855-6138
AD  - Department of Anesthesiology, Chiba University Graduate School of Medicine, 1-8-1 
      Inohana Chuo, Chiba, 260-8670, Japan. nnoztag@faculty.chiba-u.jp.
FAU - Hayashida, Taiichiro
AU  - Hayashida T
AD  - Department of Anesthesiology, Chiba University Graduate School of Medicine, 1-8-1 
      Inohana Chuo, Chiba, 260-8670, Japan.
FAU - Isono, Shiroh
AU  - Isono S
AD  - Department of Anesthesiology, Chiba University Graduate School of Medicine, 1-8-1 
      Inohana Chuo, Chiba, 260-8670, Japan.
LA  - eng
PT  - Journal Article
DEP - 20201020
PL  - Germany
TA  - JA Clin Rep
JT  - JA clinical reports
JID - 101682121
PMC - PMC7575662
OTO - NOTNLM
OT  - Analgesia
OT  - Dyspnea relieving effect
OT  - Experimental pain
OT  - Non-respiratory sensation period
OT  - Opioid
COIS- The authors declare that they have no competing interests.
EDAT- 2020/10/21 06:00
MHDA- 2020/10/21 06:01
PMCR- 2020/10/20
CRDT- 2020/10/20 12:13
PHST- 2020/09/14 00:00 [received]
PHST- 2020/10/08 00:00 [accepted]
PHST- 2020/10/05 00:00 [revised]
PHST- 2020/10/20 12:13 [entrez]
PHST- 2020/10/21 06:00 [pubmed]
PHST- 2020/10/21 06:01 [medline]
PHST- 2020/10/20 00:00 [pmc-release]
AID - 10.1186/s40981-020-00391-y [pii]
AID - 391 [pii]
AID - 10.1186/s40981-020-00391-y [doi]
PST - epublish
SO  - JA Clin Rep. 2020 Oct 20;6(1):85. doi: 10.1186/s40981-020-00391-y.