Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

02 September 2009

Hyperalgesia during opiate escalation in a patient with sickle cell anemia managed by de-escalation of opiates

Chinedu Ivonye, Susan Hanson, Abdurahman Emsalem, Emmanuel Onasile, Vishal Parekh, Christopher Phillips, Stephanie Garrett

Am J Case Rep 2009; 10:126-128 :: ID: 878182

Abstract

Background: Traditionally, using opioid analgesics to treat of sickle cell pain, a decline in analgesic efficacy had been thought to result from development of pharmacological tolerance or worsening symptoms. Opioids intended to abolish pain can unexpectedly produce hyperalgesia, especially during rapid escalation of opioids. To avoid this adverse effect, practitioners should consider opioid switching or down escalation.
Case Report: The authors present a case report of a sickle cell patient with a crisis in which overlap switching of morphine to methadone was effective in treatment of hyperalgesia as a consequence of rapid opioid escalation. Interestingly there was clinical and symptomatic improvement when the initial opioid was switched to a low dose of a different opioid resulting in the resolution of the hyperalgesia.
Conclusions: Hyperalgesia in opioid escalation has been reported in the medical literature in cancer patients and in children with sickle cell pain crises. However the occurrence of hyperalgesia associated with opioid escalation in adults with sickle cell pain has not been suffi ciently documented in the literature. Physicians should be aware of this possible consequence of opiate therapy and how to treat it.

Keywords: sickle cell anemia, Opioid Escalation, Opioid De-escalation, Hyperalgesia

0 Comments

SARS-CoV-2/COVID-19

30 November 2022 : Case report  Gabon

Severe COVID-19 in 2 Kidney Transplant Patients in Gabon

Am J Case Rep In Press; DOI: 10.12659/AJCR.938003  

23 November 2022 : Case report  Grenada

Mepolizumab as a Potential Protective Factor of COVID-19 Mortality: A Case Report of Chronic Bronchitis and...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938450  

In Press

02 Dec 2022 : Case report  Portugal

A 54-Year-Old Woman with Papillary Thyroid Carcinoma Associated with Secondary Amyloid Goiter and Thyroid L...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938156  

02 Dec 2022 : Case report  Saudi Arabia

A 14-Year-Old Saudi Boy with Gynecomastia, Cushing Syndrome, Large-Cell Calcifying Sertoli Cell Tumor of th...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937404  

01 Dec 2022 : Case report  China (mainland)

Ureterolithiasis in Human Immunodeficiency Virus (HIV) Patients Treated with Single-Use Ureteroscope: A Cas...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938608  

01 Dec 2022 : Case report  Saudi Arabia

Ancient Schwannoma: Case Report of an Unusual Entity in an Unusual Oral Location

Am J Case Rep In Press; DOI: 10.12659/AJCR.938335  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923