The Journal of the Arkansas Medical Society
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J Ark Med Soc
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Case Reports
The epidural works, but the patient hurts! Acute pain management of the chronic pain patient.
Perioperative management of opioid-dependent patients can be a challenge to surgeons, anesthesiologists and pain specialist. Our case illustrates the consequences of poor management of this subset of patients. A 60-year-old male with history left renal mass was scheduled for a left open nephrectomy. ⋯ An epidural was placed for post-operative pain control, and opioids were discontinued during hospitalization. Forty-eight to seventy-two hours after surgery, the patient developed withdrawal symptoms. Home medications were restarted and symptoms resolved.