Patch Iii Richard K, Eldrige Jason S, Moeschler Susan M, Pingree Matthew J
Division of Critical Care Medicine, Department of Anesthesiology & Perioperative Medicine and Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Pain Medicine, Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Case Rep Anesthesiol. 2017;2017:9876306. doi: 10.1155/2017/9876306. Epub 2017 Sep 25.
Acute postoperative pain in patients with opioid tolerance creates a significant management challenge for anesthesiologists and pain medicine physicians. A multimodal approach is key; however other factors can complicate management such as opioid induced hyperalgesia. We present the case of a patient on large amounts of intrathecal opioids for chronic pain syndrome with opioid induced hyperalgesia after an exploratory laparotomy. Dexmedetomidine was utilized successfully as part of a controlled multimodal analgesic plan and should be a consideration for opioid tolerant patients experiencing opioid induced hyperalgesia.
对阿片类药物耐受的患者术后急性疼痛给麻醉医生和疼痛科医生带来了重大的管理挑战。多模式方法是关键；然而，其他因素会使管理变得复杂，比如阿片类药物诱导的痛觉过敏。我们报告一例因慢性疼痛综合征接受大量鞘内注射阿片类药物治疗的患者，在剖腹探查术后出现阿片类药物诱导的痛觉过敏。右美托咪定作为可控多模式镇痛方案的一部分被成功使用，对于经历阿片类药物诱导痛觉过敏的阿片类药物耐受患者应予以考虑。
