We would like to thank for the opportunity to reply to the important questions raised by Kendall et al. and also would like to thank the authors of that letter for their kind words (Kendall and Castro‐Alves, ).Our results indeed seem contrary to previous results about opioid‐induced hyperalgesia (OIH), but on a detailed look, there is not necessarily a contradiction. Until now, no direct link between the short‐lasting OIH and long‐term pain has been shown in humans. Although OIH may increase acute pain intensity and thus indirectly induce pain chronification, efficacious postoperative analgesia may as well be sufficient to prevent long‐lasting changes.In our study, we applied patient‐controlled analgesia infusion pumps, which seem to have effectively prevented an influence of OIH on the individual acute pain levels as our data show no significant correlation between intraoperative remifentanil consumption and the pain level at one hour after surgery (Spearman correlation coefficient rho = 0.145, p = 0.139) even though we find a strong and significant correlation between intraoperative remifentanil consumption and patient‐controlled piritramide consumption in the first hour after surgery (Spearman correlation coefficient rho = 0.350, p < 0.001), most parsimoniously explained by OIH. Our interpretation of these results is that the analgesia protocol in the early postoperative phase was
European Journal of Pain – Wiley
Published: Jan 1, 2018
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