• Anesthesia and analgesia · Dec 2007

    Case Reports

    A differential diagnosis of hyperalgesia, toxicity, and withdrawal from intrathecal morphine infusion.

    • Aneesh Singla, Milan P Stojanovic, Lucy Chen, and Jianren Mao.
    • Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. asingla@partners.org
    • Anesth. Analg. 2007 Dec 1; 105 (6): 1816-9, table of contents.

    AbstractOpioid-induced hyperalgesia, toxicity, and withdrawal are phenomena that may occur with intrathecal opioid infusion. We present a case in which a patient received intrathecal morphine infusion, and then experienced a clinical course that may have involved hyperalgesia, toxicity, and/or withdrawal. The possible differential diagnosis of opioid-induced hyperalgesia, toxicity, and withdrawal, and its implications in clinical pain management, are discussed. This report demonstrates the complexity of treating patients with long-term continuous intrathecal opioids when modest adjustment of the intrathecal cocktail results in a paradoxical clinical course.

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