Opioid-induced hyperalgesia after implantation of intrathecal morphine pump: a case report

Abstract

Opioid-induced hyperalgesia is characterized by an increased pain response to noxious stimuli despite increased use of opioid medications. Here, we report the case of a 43-year-old woman diagnosed with post-laminectomy syndrome who presented with an increasing pain score following a morphine infusion via an implanted intrathecal drug delivery device. Her pain improved after reducing opioid doses and the administration of intravenous ketamine infusion therapy. Thus, the early suspicion of opioid-induced hyperalgesia is essential for patients with increasing pain refractory to augmented doses of opioid medications.

Buprenorphine Facilitates Rapid Weaning From Very-High-Dose Intrathecal Hydromorphone

“…OIH results in a paradoxical increase in pain, suffering, hyperalgesia, and allodynia despite the escalation of opioid therapy. Prior case reports have documented OIH resulting from intrathecal fentanyl [ 7 ], morphine [ 8 ], and sufentanil [ 9 ]. Opioids, especially after chronic exposure, also create a state of tolerance, where escalating doses are required to achieve the same result.…”