[libribook.com] Traumatic Scar Tissue Management 1st Edition

Clinical Consideration
Neuropathic pain may be resistant or less responsive to opioid therapy,
suggesting the necessity of using alternative analgesics to achieve pain
relief in patients with neuropathic pain (Wilkie et al. 2001). Additionally,
there is growing concern over the detrimental side effects, including
opioid-induced hyperalgesia. Although this family of drugs provides
analgesic and antihyperalgesic effects initially, subsequently they are
associated with the expression of hyperalgesia, suggesting that opioids can
activate both pain inhibitory and pain facilitatory systems. Paradoxically,
opioid therapy aiming at alleviating pain may render patients more
sensitive to pain and potentially may aggravate their pre-existing pain
(Angst & Clark 2006).