Related Experiment Video
Updated: Feb 4, 2026

Author Spotlight: An Efficient Methodology to Confidently Differentiate and Characterize Fentanyl Analogs
Published on: November 8, 2024
Opioid Induced Hyperalgesia with Intrathecal Infusion of High-Dose Fentanyl
Antranig Kalaydjian1,2, Fadi Farah1,2, Yuen Cheng1,2
1Department of Anesthesiology, Critical Care & Pain Medicine, St Elizabeth Medical Center, Boston, Massachusetts, U.S.A.
Introduction:
Despite being reported since 1943 as well as being the subject of a large body of literature since that time, no consensus has been reached regarding the etiology of opioid induced hyperalgesia (OIH). It is often described as a paradoxical increased pain response to noxious stimuli due to increased sensitization or an acute tolerance to opioids.
Case:
We report the case of a 60 year old patient on chronic Intrathecal combined fentanyl and Bupivacaine who had worsening pain with increasing doses and improved after weaning off intrathecal opioids.
Conclusion:
OIH has been described in various settings including patients on methadone maintenance therapy, perioperative opioid administration, cancer patients on opioids, and healthy volunteers who are acutely exposed to opioids, including high dose intrathecal opioids such as Morphine and Sufentanil. To our knowledge, no cases of opioid induced hyperalgesia was previously reported in the case of intrathecal Fentanyl.
Related Concept Videos
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Opioid Receptors: Overview
Opioid Analgesics: Morphine and Other Natural Cogeners
Dose Size and Dosing Frequency: Determination Methods
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...

