Prevention of post-operative hyperalgesia in a heroin-addicted patient on methadone maintenance

Roberta Barelli, Gloria Morelli Sbarra, Fabio Sbaraglia, Luca Zappia, Marco Rossi

Research output: Contribution to journalArticlepeer-review


WHAT IS KNOWN AND OBJECTIVE: The exponential increase in chronic opioid consumers resulted in more challenges regarding post-operative pain management. Considering the usual hyperalgesic response to pain and the increased opioid-tolerance, a multidrug approach should be desirable.

CASE DESCRIPTION: We described the strategy in pain management of a patient receiving methadone maintenance treatment, who underwent surgery associated with moderate post-operative pain. The combination of balanced general anaesthesia and intraoperative continuous low-dose infusion of ketamine assured an appropriate control of post-operative pain without increasing opioid consumption. Besides, it was not associated with psychomimetic effects.

WHAT IS NEW AND CONCLUSION: Ketamine can effectively reduce opioid requirements in chronic opioid users on methadone maintenance therapy and should therefore be considered promptly as part of a multimodal perioperative analgesia management in this category of patients.

Original languageEnglish
Pages (from-to)397-399
Number of pages3
JournalJournal of Clinical Pharmacy and Therapeutics
Issue number3
Publication statusPublished - Jun 2019


  • Analgesics, Opioid/therapeutic use
  • Heroin/adverse effects
  • Humans
  • Hyperalgesia/prevention & control
  • Ketamine/therapeutic use
  • Male
  • Methadone/therapeutic use
  • Middle Aged
  • Opioid-Related Disorders/complications
  • Pain Management/methods
  • Pain, Postoperative/drug therapy
  • Perioperative Care
  • Postoperative Period

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