Pain managements in pancreatic cancer patient with opioid-induced hyperalgesia: A case report.
- Author:
Jung Hyun PARK
1
;
Dae Hwan LIM
;
Young Hoon KIM
;
Keon Hee RYU
;
Dong Eon MOON
Author Information
1. Department of Anesthesiology and Pain Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. demoon@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Cancer pain;
Opioid;
Opioid-induced hyperalgesia
- MeSH:
Abdominal Pain;
Analgesia;
Analgesics;
Analgesics, Opioid;
Catheters;
Celiac Plexus;
Female;
Humans;
Hyperalgesia;
Middle Aged;
Pain Management;
Pancreatic Neoplasms;
Stress, Psychological
- From:Anesthesia and Pain Medicine
2012;7(2):110-113
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Opioids are generally used to treat severe cancer pain. Usually, it is common to increase the dose of opioids to maintain analgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical response to opioid resulting in increased perception of pain rather than antinociceptive effect. A 64-year-old female with pancreatic cancer was suffering from whole abdominal pain. She took massive opioid therapy, however, her pain had been worse and widen in the 3 months. Radiologic imaging was performed to exclude metastatic cancer. The result was negative. We suspected OIH, and reduced the amount of opioids, then, added to adjuvant analgesics. And also we performed celiac plexus neurolysis with the use of alcohol and continuous epidural catheter insertion. Her numeric rating pain scale (NRS) decreased from 9/10 to 3/10. This case suggests that adjuvant analgesics and interventional treatments can resolve a OIH patient with intractable cancer pain.
