Opioid-Induced Hyperalgesia and Rapid Opioid Detoxification After Tacrolimus Administration

In Brief Opioids can induce central sensitization and hyperalgesia, referred to as “opioid-induced hyperalgesia.” Our report describes a patient who underwent intestinal transplant followed by immunosuppressant-related neuropathic pain. Her pain was treated with limited success over the course of 3 yr with different therapies, including IV morphine. She developed opioid-induced hyperalgesia, which was successfully treated with rapid detoxification under general anesthesia. Detoxification improved her quality of life, including the ability to resume physiotherapy. Six months after treatment, she remained opioid free. Our experience suggests that rapid detoxification under general anesthesia may be an effective treatment for opioid-induced hyperalgesia and merits comparison to traditional detoxification methods. IMPLICATIONS: The authors report a case of opioid-induced hyperalgesia in a patient receiving IV morphine with chronic neuropathic pain, and the favorable response to opioid detoxification.