Severe intraoperative hypertension and opioid-resistant postoperative pain in a methadone-treated patient.
Patients who are treated with methadone present challenges for the anesthesiologist. We report the untoward effects of rapid preoperative methadone tapering on the operative and perioperative course of a patient who required emergency surgery. The patient's exaggerated stress response to surgery and severe intractable postoperative pain might have resulted from unrecognized methadone withdrawal. Continuation of methadone treatment in patients who have surgery may prevent exaggerated intraoperative hemodynamic responses to surgical stimuli and unnecessary postoperative suffering.
Friedman
Robert
R
Department of Anesthesiology, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.
Kamel
Ihab
I
Perez
Cara
C
Hamada
Aboulnasr
A
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D004351:Drug Resistance; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000503:physiopathology*; D007431:Intraoperative Complications / Q000139:chemically induced / Q000503:physiopathology*; D008691:Methadone / Q000009:adverse effects*; D010148:Intractable Pain / Q000188:drug therapy*; D010149:Postoperative Pain / Q000188:drug therapy*; D012006:Rectovaginal Fistula / Q000601:surgery; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology*
D000701:Analgesics, Opioid; D008691:Methadone