Open AccessEpidural dexmedetomidine infusion in a patient with chronic opioid use and intractable pain following abdominoperineal resection
Author(s) -
Mathew P Silvaggio,
Melanie K Toman,
Braden Peters
Publication year - 2020
Publication title -
oxford medical case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.169
H-Index - 9
ISSN - 2053-8855
DOI - 10.1093/omcr/omaa021
Subject(s) - dexmedetomidine , medicine , perioperative , anesthesia , analgesic , chronic pain , abdominoperineal resection , opioid , intractable pain , population , surgery , sedation , cancer , colorectal cancer , physical therapy , receptor , environmental health
Dexmedetomidine is a selective alpha 2 adrenergic agonist with known analgesic properties. Its perioperative use is associated with reduced pain scores and an opioid sparing effect. Management of postoperative pain in patients with a history of chronic opioid use can be challenging. Multimodal analgesia is recommended although the perioperative use of dexmedetomidine has not been extensively studied in this patient population. We present a case of intractable abdominal pain following open abdominoperineal resection in a patient with rectal cancer and a history of chronic opioid use. Following the introduction of dexmedetomidine into the patient’s postoperative epidural solution, a noticeable decline in reported pain scores and use of breakthrough analgesia was appreciated. The analgesic efficacy of epidural dexmedetomidine in patients with a history of chronic opioid use warrants further study.