Case report: Opioid tolerance and hyperalgesia after abdominal injury

  • Mario Hernán Villegas-Pineda a. Fundación Valle del Lili, Cali, Colombia. b. Anaesthesia Department, Universidad del Valle, Cali, Colombia
  • Carlos Andrés Palacio-García Universidad del Valle, Cali, Colombia
Keywords: Pain management, Analgesics opioid, Ketamine, Dexmedetomidine, Hyperalgesia

Abstract

Introduction: 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.

Conclusion: Opioid 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.

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How to Cite
1.
Villegas-Pineda MH, Palacio-García CA. Case report: Opioid tolerance and hyperalgesia after abdominal injury. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021May12];45(Supplement):12 -15. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/436

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Published
2017-04-01
How to Cite
1.
Villegas-Pineda MH, Palacio-García CA. Case report: Opioid tolerance and hyperalgesia after abdominal injury. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021May12];45(Supplement):12 -15. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/436
Section
Case Report / Case Series

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