Korean J Hosp Palliat Care.  2019 Jun;22(2):100-104. 10.0000/kjhpc.2019.22.2.100.

Two Cases of Opioid-Induced Hyperalgesia in Cancer Patients Treated with Opioids for Pain Management

Affiliations
  • 1Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea. kwonjhye.onco@gmail.com
  • 2Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
  • 3Palliative Care Clinic, Kangdong Sacred Heart Hospital, Seoul, Korea.

Abstract

Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.

Keyword

Neoplasms; Pain; Opioid analgesics; Hyperalgesia

MeSH Terms

Analgesics, Opioid*
Cognition Disorders
Delirium
Hallucinations
Humans
Hyperalgesia*
Myoclonus
N-Methylaspartate
Pain Management*
Respiratory Insufficiency
Seizures
Sleep Stages
Analgesics, Opioid
N-Methylaspartate
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