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Anesth Analg 2008; 106:645-646
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181602c3e
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PAIN MEDICINE

Opioid-Induced Hyperalgesia and Rapid Opioid Detoxification After Tacrolimus Administration

Antonio Siniscalchi, MD{dagger}, Emanuele Piraccini, MD*, Zuzana Miklosova, MD*, Stefania Taddei, MD{dagger}, Stefano Faenza, MD, Mph*, and Gerardo Martinelli, MD, Mph*

From the Department of Anesthesiology, *University of Bologna, {dagger}S.Orsola-Malpighi Hospital, Bologna, Italy.

Address correspondence and reprint requests to Emanuele Piraccini, Department of Anesthesiology, S.Orsola-Malpighi Hospital, via Massarenti 9, 40137 Bologna, Italy. Address e-mail to dremanuelepiraccini{at}yahoo.it.

Opioids can induce central sensitization and hyperalgesia, referred to as "opioid-induced hyperalgesia." Our report describes a patient who underwent intestinal transplant followed by immunosuppressant-related neuropathic pain. Her pain was treated with limited success over the course of 3 yr with different therapies, including IV morphine. She developed opioid-induced hyperalgesia, which was successfully treated with rapid detoxification under general anesthesia. Detoxification improved her quality of life, including the ability to resume physiotherapy. Six months after treatment, she remained opioid free. Our experience suggests that rapid detoxification under general anesthesia may be an effective treatment for opioid-induced hyperalgesia and merits comparison to traditional detoxification methods.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.