Case report: Opioid tolerance and hyperalgesia after abdominal injury
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- 作者：Mario Herná ; n Villegas-Pineda<sup>asup><sup> ; sup><sup>bsup><sup> ; sup><sup>mahervi59@hotmail.comsup> ; Carlos André ; s Palacio-Garcí ; a<sup>csup>
- 关键词：Pain management ; Analgesics ; opioid ; Ketamine ; Dexmedetomidine ; Hyperalgesia
- 刊名：Colombian Journal of Anesthesiology
- 出版年：2017
- 出版时间：January 2017
- 年：2017
- 卷：45
- 期：supp_S1
- 页码：12-15
- 全文大小：439 K
- 卷排序：45
文摘
Opioid tolerance and hyperalgesia are two occurrences that can pose great difficulty in managing both acute and chronic pain. The diagnostic and therapeutic approach requires profound knowledge of opioid pharmacology and related issues such as addiction and pseudoaddiction.This paper presents the case of a patient with multiple interventions, non-functional gastrointestinal tract, increasing uncontrolled pain, exposed to high-dose opioids.Opioid tolerance and hyperalgesia were diagnosed. An opioid rotation regimen was initiated followed by ketamine and dexmedetomidine infusions until a response was finally obtained.ConclusionOpioid tolerance and hyperalgesia are very difficult to manage and treatment is very complex in the absence of a functional gastrointestinal tract. Opioid rotation, ketamine and dexmedetomidine were the mainstays of treatment in this case.