A patient with intractable pain on high dose opioid therapy. Could we manage not to escalate the opioid dose?

Piotr Sobanski; Malgorzata Krajnik; Lucas Ritz; Felix Schläfli; Jan Kobialka; Zbigniew Zylicz

Vol 11, No 1 (2012)

Case reports

Published online: 2012-11-02

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A patient with intractable pain on high dose opioid therapy. Could we manage not to escalate the opioid dose?

Piotr Sobanski, Malgorzata Krajnik, Lucas Ritz, Felix Schläfli, Jan Kobialka, Zbigniew Zylicz

Advances in Palliative Medicine 2012;11(1):36-40.

Vol 11, No 1 (2012)

Case reports

Published online: 2012-11-02

Abstract

Prolonged opioid treatment reveals problems, like opioid tolerance and opioid induced hyperalgesia. On every stage of disease it should be remembered to use procedures that can have opioid dose sparing effect. We describe a patient with severe mixed neuropathic and nociceptive pain who despite complex medication embracing high dose of morphine suffered from untractable pain. He responded to opioid antagonist with sequential opioid rotation and a simple minimally invasive procedure.