What is known and objective: The exponential increase in chronic opioid consumers resulted in more challenges regarding post-operative pain management. Considering the usual hyperalgesic response to pain and the increased opioid-tolerance, a multidrug approach should be desirable. Case description: We described the strategy in pain management of a patient receiving methadone maintenance treatment, who underwent surgery associated with moderate post-operative pain. The combination of balanced general anaesthesia and intraoperative continuous low-dose infusion of ketamine assured an appropriate control of post-operative pain without increasing opioid consumption. Besides, it was not associated with psychomimetic effects. What is new and conclusion: Ketamine can effectively reduce opioid requirements in chronic opioid users on methadone maintenance therapy and should therefore be considered promptly as part of a multimodal perioperative analgesia management in this category of patients.

Barelli, R., Morelli Sbarra, G., Sbaraglia, F., Zappia, L., Rossi, M., Prevention of post-operative hyperalgesia in a heroin-addicted patient on methadone maintenance, <<JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS>>, 2019; 44 (3): 397-399. [doi:10.1111/jcpt.12798] [http://hdl.handle.net/10807/170687]

Prevention of post-operative hyperalgesia in a heroin-addicted patient on methadone maintenance

Morelli Sbarra, G.;Zappia, L.;Rossi, M.
2019

Abstract

What is known and objective: The exponential increase in chronic opioid consumers resulted in more challenges regarding post-operative pain management. Considering the usual hyperalgesic response to pain and the increased opioid-tolerance, a multidrug approach should be desirable. Case description: We described the strategy in pain management of a patient receiving methadone maintenance treatment, who underwent surgery associated with moderate post-operative pain. The combination of balanced general anaesthesia and intraoperative continuous low-dose infusion of ketamine assured an appropriate control of post-operative pain without increasing opioid consumption. Besides, it was not associated with psychomimetic effects. What is new and conclusion: Ketamine can effectively reduce opioid requirements in chronic opioid users on methadone maintenance therapy and should therefore be considered promptly as part of a multimodal perioperative analgesia management in this category of patients.
Inglese
Barelli, R., Morelli Sbarra, G., Sbaraglia, F., Zappia, L., Rossi, M., Prevention of post-operative hyperalgesia in a heroin-addicted patient on methadone maintenance, <<JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS>>, 2019; 44 (3): 397-399. [doi:10.1111/jcpt.12798] [http://hdl.handle.net/10807/170687]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/170687
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