Anesth Pain Med.  2012 Apr;7(2):110-113.

Pain managements in pancreatic cancer patient with opioid-induced hyperalgesia: A case report

• Park JH
• Lim DH
• Kim YH
• Ryu KH
• Moon DE

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.

Keyword

Cancer pain; Opioid; Opioid-induced hyperalgesia

MeSH Terms

Abdominal Pain
Analgesia
Analgesics
Analgesics, Opioid
Catheters
Celiac Plexus
Female
Humans
Hyperalgesia
Middle Aged
Pain Management
Pancreatic Neoplasms
Stress, Psychological
Analgesics
Analgesics, Opioid