Opioid-induced hyperalgesia and rapid opioid detoxification after tacrolimus administration.
Opioids can induce central sensitization and hyperalgesia, referred to as "opioid-induced hyperalgesia." Our report describes a patient who underwent intestinal transplant followed by immunosuppressant-related neuropathic pain. Her pain was treated with limited success over the course of 3 yr with different therapies, including i.v. morphine. She developed opioid-induced hyperalgesia, which was successfully treated with rapid detoxification under general anesthesia. Detoxification improved her quality of life, including the ability to resume physiotherapy. Six months after treatment, she remained opioid free. Our experience suggests that rapid detoxification under general anesthesia may be an effective treatment for opioid-induced hyperalgesia and merits comparison to traditional detoxification methods.
Siniscalchi
Antonio
A
Department of Anesthesiology, S.Orsola-Malpighi Hospital, Bologna, Italy.
Piraccini
Emanuele
E
Miklosova
Zuzana
Z
Taddei
Stefania
S
Faenza
Stefano
S
Martinelli
Gerardo
G
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D008658:Inactivation, Metabolic; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000628:therapy; D010147:Pain Measurement / Q000187:drug effects; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects*
D000701:Analgesics, Opioid; D016559:Tacrolimus