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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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
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Calcium channel blocker
Case Report
Case Reports
fentanyl
nifedipine
opioid withdrawal syndrome
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cited_by cdi_FETCH-LOGICAL-c3262-c249d1598122143f0db2b56eda2259b48d56cff8a404271efef36e0e60ef28013
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container_issue 2
container_start_page 114
container_title Acute medicine & surgery
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creator Shimatani, Tatsutoshi
Adachi, Hiroshi
Mihashi, Hiroyuki
Usumoto, Noriko
Yoshimoto, Kohei
Ayukawa, Katsuhiko
description 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.
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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. 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subjects Calcium channel blocker
Case Report
Case Reports
fentanyl
nifedipine
opioid withdrawal syndrome
title Calcium channel blocker attenuated opioid withdrawal syndrome
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