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Calcium channel blocker attenuated opioid withdrawal syndrome

Tatsutoshi Shimatani¹, Hiroshi Adachi¹, Hiroyuki Mihashi²

¹Department of Emergency and Critical Care Center Iizuka Hospital Iizuka Fukuoka Japan.

Acute Medicine & Surgery

|November 11, 2017

Abstract

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.

Keywords:

Calcium channel blocker fentanyl nifedipine opioid withdrawal syndrome

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