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Severe intraoperative hypertension and opioid-resistant postoperative pain in a methadone-treated patient
Robert Friedman1, Ihab Kamel, Cara Perez
1Department of Anesthesiology, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.
Abstract:
Patients who are treated with methadone present challenges for the anesthesiologist. We report the untoward effects of rapid preoperative methadone tapering on the operative and perioperative course of a patient who required emergency surgery. The patient's exaggerated stress response to surgery and severe intractable postoperative pain might have resulted from unrecognized methadone withdrawal. Continuation of methadone treatment in patients who have surgery may prevent exaggerated intraoperative hemodynamic responses to surgical stimuli and unnecessary postoperative suffering.
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