Dexmedetomidine: Opioid-sparing measure for opioid-tolerant patients

Abstract

As many as 50 million Americans suffer from chronic pain, opioid therapy is often the treatment modality to provide relief. Unfortunately, the long-term use of opioids can have the untoward effect of reduced effectiveness and opioid-tolerance. Often, this situation eventually leads the patient to seek surgical intervention for the relief of their pain. Anesthesia providers then find themselves facing the complex issue of providing adequate pain control to these opioid-tolerant patients while ensuring safe care in the surgical and postoperative settings. A case study was conducted which focused on an opioid-tolerant patient who underwent spinal surgery. The patient had been prescribed opioid therapy for chronic back pain. Over the last four years, the patient's pain continued to worsen while his opioid consumption increased to a point that the patient and surgeon agreed surgical intervention would be the next step.