title: Is mechanism and symptom-based analgesia an answer to opioid-induced hyperalgesia?
abstract: "Cancer Pain" and "Pain in cancer patient" are not synonymous. Opioid-induced Hyperalgesia (OIH) is a paradoxical state of nociceptive sensitization caused by exposure to opioids. Neuropathic pain is only partially responsive to opioids; injudicious increase in dose of opioids in neuropathic pain may not only result in inadequate pain relief but also OIH. Majority of literature on OIH is in non-cancer pain with systemic use of opioids. We describe the development and successful treatment of OIH in a 55-year-old male patient with Small cell Carcinoma Lung. Opioid tapering, rotation, systemic desensitization helps in combatting OIH. The use of anti-neuropathic adjuvant analgesics helps not only in preventing and treating OIH but also in understanding putative mechanisms underlying neuropathic pain and OIH.
authors.affiliation: Department of Medical Intensive Care Unit and Pain, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Employee's State Insurance Hospital, Okhla, Delhi, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Gupta
keywords: Mechanism based; opioid induced hyperalgesia; opioids