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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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
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author Nozaki-Taguchi, Natsuko
Ueda, Yuko
Inada, Azusa
Son, Kyongsuk
Isono, Shiroh
author_facet Nozaki-Taguchi, Natsuko
Ueda, Yuko
Inada, Azusa
Son, Kyongsuk
Isono, Shiroh
author_sort Nozaki-Taguchi, Natsuko
collection PubMed
description 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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spelling pubmed-73299622020-07-07 A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression Nozaki-Taguchi, Natsuko Ueda, Yuko Inada, Azusa Son, Kyongsuk Isono, Shiroh JA Clin Rep Case Report 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. Springer Berlin Heidelberg 2020-07-01 /pmc/articles/PMC7329962/ /pubmed/32613464 http://dx.doi.org/10.1186/s40981-020-00355-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Report
Nozaki-Taguchi, Natsuko
Ueda, Yuko
Inada, Azusa
Son, Kyongsuk
Isono, Shiroh
A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
title A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
title_full A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
title_fullStr A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
title_full_unstemmed A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
title_short A report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
title_sort report of three cancer patients on opioid analgesia receiving spinal anesthesia: abrupt pain elimination without respiratory depression
topic Case Report
url 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
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