Singla Aneesh, Stojanovic Milan P, Chen Lucy, Mao Jianren
Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Anesth Analg. 2007 Dec;105(6):1816-9, table of contents. doi: 10.1213/01.ane.0000290338.39037.38.
Opioid-induced hyperalgesia, toxicity, and withdrawal are phenomena that may occur with intrathecal opioid infusion. We present a case in which a patient received intrathecal morphine infusion, and then experienced a clinical course that may have involved hyperalgesia, toxicity, and/or withdrawal. The possible differential diagnosis of opioid-induced hyperalgesia, toxicity, and withdrawal, and its implications in clinical pain management, are discussed. This report demonstrates the complexity of treating patients with long-term continuous intrathecal opioids when modest adjustment of the intrathecal cocktail results in a paradoxical clinical course.
阿片类药物引起的痛觉过敏、毒性反应和戒断反应是鞘内注射阿片类药物时可能出现的现象。我们报告一例患者，该患者接受了鞘内吗啡输注，随后经历了一个可能涉及痛觉过敏、毒性反应和/或戒断反应的临床过程。本文讨论了阿片类药物引起的痛觉过敏、毒性反应和戒断反应的可能鉴别诊断及其在临床疼痛管理中的意义。本报告表明，当鞘内混合药物进行适度调整却导致矛盾的临床过程时，治疗长期持续鞘内使用阿片类药物的患者具有复杂性。
