A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression

BACKGROUND: Complete removal of pain with regional anesthesia has been reported to cause fatal respiratory depression in opioid-dependent patients, which leads us to choose general anesthesia. We hereby report three cases of chronically opioid-treated cancer patients operated under spinal anesthesia...

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Detalles Bibliográficos
Autores principales: Nozaki-Taguchi, Natsuko, Ueda, Yuko, Inada, Azusa, Son, Kyongsuk, Isono, Shiroh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329962/
https://www.ncbi.nlm.nih.gov/pubmed/32613464
http://dx.doi.org/10.1186/s40981-020-00355-2
Descripción
Sumario:BACKGROUND: Complete removal of pain with regional anesthesia has been reported to cause fatal respiratory depression in opioid-dependent patients, which leads us to choose general anesthesia. We hereby report three cases of chronically opioid-treated cancer patients operated under spinal anesthesia without respiratory event. CASE PRESENTATION: Case 1: a 32-year-old female treated with high-dose morphine for her cancer pain was planned for cesarean section. Case 2: a 65-year-old female on moderate dose of oxycodone was planned for surgery of her femoral bone fracture. Case 3: a 65-year-old male on low-dose oxycodone was planned for intramedullary nailing for metastatic femoral bone tumor. In all three cases, spinal anesthesia was chosen. Continuous respiratory monitoring revealed no apnea or bradypnea. CONCLUSION: Spinal anesthesia was safely performed without respiratory depression in chronic opioid users for cancer pain.

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