title: Long-term opioid treatment in Behçet's syndrome with intractable abdominal pain--a case report.
abstract: Opioids are the most potent and effective analgesics available for treating acute and chronic cancer pain, but its usefulness in treating non-cancer chronic pain is still controversial. We report a 23-year-old male suffering from Behçet's disease with persistent excruciating abdominal pain. Oral non-steroid anti-inflammation analgesics and milder opioids (codeine and tramadol) failed to relieve the pain. His excruciating abdominal pain resulting from ulcerative viscera aggravated with repeated gastrointestinal tract surgeries. Intravenous morphine given through patient-controlled analgesia (PCA) could effectively reduce his pain with minimal side effects. No sign of physical or psychological dependence was observed during the period of opiate administration, and no withdrawal phenomenon was found as the dosage was tapered. During the total treatment course of 213 days, the daily dose of morphine once surged up to 259.2 mg. The long-term opioid treatment and its possible effects are, herein, discussed.
authors.affiliation: Department of Anesthesiology, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95, Wen-Chung Rd., Taipei, 10111, Taiwan, R.O.C.
authors.forename: Hsiang-Chien
authors.initials: HC
authors.lastname: Tseng
authors.forename: Yeong-Ray
authors.initials: YR
authors.lastname: Wen
authors.forename: Jui-Yuan
authors.initials: JY
authors.lastname: Chen
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Lee
authors.forename: Gong-Jhe
authors.initials: GJ
authors.lastname: Wu
authors.forename: Yi
authors.initials: Y
authors.lastname: Chang
authors.forename: Shan-Chung
authors.initials: SC
authors.lastname: Swei
mesh_terms: D015746:Abdominal Pain / Q000188:drug therapy*; D000328:Adult; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001528:Behcet Syndrome / Q000188:drug therapy*; D004361:Drug Tolerance; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D010148:Intractable Pain / Q000188:drug therapy*; D016194:Receptors, N-Methyl-D-Aspartate / Q000037:antagonists & inhibitors
chemical_list: D000701:Analgesics, Opioid; D018691:Excitatory Amino Acid Antagonists; D016194:Receptors, N-Methyl-D-Aspartate; D009020:Morphine