Perioperative dilemma: Challenges of the management of a patient on mega doses of morphine and methadone
| Autor: | Alan David Kaye, Md, PhD, Daba, Dabpm, Dabipp, Keun Sam Chung, Aymen A. Alian, Nalini Vadivelu |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
N-Methylaspartate
Neoplasms Back pain Humans Medicine Pharmacology (medical) Opioid-induced hyperalgesia Aged Pain Postoperative Morphine business.industry General Medicine Perioperative Pain Intractable Clonidine Anesthesiology and Pain Medicine Opioid Anesthesia Female medicine.symptom business Cancer pain Methadone medicine.drug |
| Zdroj: | Journal of Opioid Management. 10:69-72 |
| ISSN: | 1551-7489 |
| DOI: | 10.5055/jom.2014.0194 |
| Popis: | High doses of opioids are often needed in the management of cancer-related pain. A discussion of a patient’s perioperative opioid management and mechanisms contributing to opioid-induced hyperalgesia (OIH) are presented. In the present case report, a patient on high doses of opioids, including morphine and methadone, with severe worsening back pain and a history of increasing opioid requirements for the last 2 months due to metastatic leiomyosarcoma to the femur, spine, and neck is described. Use of high dose opioids is associated with numerous challenges, including tolerance. The successful management of this patient was multimodal and included the use of potent analgesics, N-methyl-D-aspartatereceptor antagonists, and the α-2 agonist clonidine. |
| Databáze: | OpenAIRE |
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