Transitioning From Intrathecal Hydromorphone to Sublingual Buprenorphine-Naloxone Through Microdosing: A Case Report

被引：9

作者：

Crum, Isaiah T. ^{[1
]}

Meyer Karre, VaKara M. ^{[1
]}

Balasanova, Alena A. ^{[1
]}

机构：

[1] Univ Nebraska Med Ctr, Coll Med, Dept Psychiat, Poynter Hall,5th Floor, Omaha, NE 68198 USA

来源：

A & A PRACTICE | 2020年 / 14卷 / 11期

关键词：

FULL-OPIOID AGONISTS; DEPENDENCE; CONVERSION;

D O I：

10.1213/XAA.0000000000001316

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

A 76-year-old woman with chronic noncancer pain and an intrathecal hydromorphone-bupivacaine pump was admitted for acute exacerbation of heart failure. Her pump was unable to be replaced due to medical comorbidities. She was unable to tolerate oral opioids due to ventilatory depression. Tapering hydromorphone resulted in opioid withdrawal due to physiological dependence. Microdosing of sublingual buprenorphine-naloxone was initiated while decreasing intrathecal hydromorphone. This successfully weaned the patient off intrathecal hydromorphone with adequate pain relief and prevented both opioid withdrawal and ventilatory depression. To our knowledge, microdosing buprenorphine-naloxone to assist with discontinuing intrathecal opioids has not been previously reported in the literature.

引用

页数：3

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