Calcium channel blocker attenuated opioid withdrawal syndrome

Case A 61‐year‐old woman was diagnosed with deep cervical abscess and enlarged mediastinal abscess. These required a protracted period of mechanical ventilation and neck and thoracic drainage surgery with daily wound lavage, necessitating the administration of large amounts of fentanyl and dexmedeto...

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Bibliographic Details
Published in:Acute medicine & surgery 2015-04, Vol.2 (2), p.114-116
Main Authors: Shimatani, Tatsutoshi, Adachi, Hiroshi, Mihashi, Hiroyuki, Usumoto, Noriko, Yoshimoto, Kohei, Ayukawa, Katsuhiko
Format: Article
Language:English
Subjects:
Calcium channel blocker
Case Report
Case Reports
fentanyl
nifedipine
opioid withdrawal syndrome
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Summary:Case A 61‐year‐old woman was diagnosed with deep cervical abscess and enlarged mediastinal abscess. These required a protracted period of mechanical ventilation and neck and thoracic drainage surgery with daily wound lavage, necessitating the administration of large amounts of fentanyl and dexmedetomidine. After extubation, fentanyl was discontinued but dexmedetomidine was continued, and she developed hypertension, tachycardia, tachypnea, and hyperthermia within several hours; therefore, she was diagnosed with opioid withdrawal syndrome. Her symptoms failed to improve with either an increased dexmedetomidine dose or a diltiazem infusion for symptomatic management. Ultimately, 20 mg nifedipine was given through a nasogastric tube, which led to a resolution of withdrawal symptoms. Outcome This is the first case of calcium channel blockers attenuating opioid withdrawal syndrome symptoms in a human. Conclusion Calcium channel blockers might be alternative therapy to refractory opioid withdrawal syndrome. Case accumulation in the future is expected.
ISSN:2052-8817
2052-8817
DOI:10.1002/ams2.72