title: Opioid-induced hyperalgesia and rapid opioid detoxification after tacrolimus administration.
abstract: 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.
authors.affiliation: Department of Anesthesiology, S.Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Siniscalchi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Piraccini
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Miklosova
authors.forename: Stefania
authors.initials: S
authors.lastname: Taddei
authors.forename: Stefano
authors.initials: S
authors.lastname: Faenza
authors.forename: Gerardo
authors.initials: G
authors.lastname: Martinelli
mesh_terms: 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*
chemical_list: D000701:Analgesics, Opioid; D016559:Tacrolimus