• J Pain Palliat Care Pharmacother · Sep 2024

    Navigating the Postoperative Management of Remifentanil-Induced Hyperalgesia: A Case Report.

    • Nathan T Smith, Ryan Fernholz, and Sanny Juresic.
    • PharmD, Pharmacy, Mayo Clinic, Rochester, NY, USA.
    • J Pain Palliat Care Pharmacother. 2024 Sep 9: 161-6.

    AbstractOpioid induced hyperalgesia in the postoperative setting presents a significant challenge for clinicians managing postoperative pain in opioid tolerant patients. Remifentanil is a fentanyl analog frequently utilized in anesthesia for its favorable pharmacokinetic profile. However, as described in the case report, it may also increase the risk of postoperative hyperalgesia. Management of postoperative pain in the setting of hyperalgesia should be approached in a stepwise fashion, emphasizing therapy options with analgesic effects achieved outside of the opioidergic system while maintaining a neutral opioid balance.

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