Acute opioid withdrawal following the discontinuation of a short term epidural fentanyl infusion

  • Roland Kaddoum American University of Beirut, P. O. Box 11-0236, Riad el Solh1107,1107-2020 (Lebanon)
  • Carine Foz American University of Beirut, P. O. Box 11-0236, Riad el Solh1107,1107-2020 (Lebanon)
  • Muhammad Ibrahim American University of Beirut, P. O. Box 11-0236, Riad el Solh1107,1107-2020 (Lebanon)
  • Doralina Anghelescu Director of the Pain Management Service, St. Jude Children’s research Hospital, Memphis, Tennessee (USA)
Keywords: Opioid withdrawal, Epidural, Fentanyl, Pain, Postoperative

Abstract

Acute opioid withdrawal has been described after interruption of prolonged intrathecal opioids but has
not been reported after discontinuation of epidural fentanyl. A 60 year old male underwent a Whipple
procedure and T7 thoracic epidural was placed for postoperative pain management using bupivacaine
0.1% with fentanyl 2 μg/ml started at a rate of 6 ml/hr. On the third postoperative day the epidural was
discontinued. The patient developed acute opioid withdrawal after four hours of discontinuation, to be
relieved by intravenous tramadol and fentanyl. The epidural infusion was resumed and tapered down
gradually over a period of 12 hrs with no recurrence of withdrawal symptoms.

Published
01-25-2019
How to Cite
Kaddoum, R., Foz, C., Ibrahim, M., & Anghelescu, D. (2019). Acute opioid withdrawal following the discontinuation of a short term epidural fentanyl infusion. Anaesthesia, Pain & Intensive Care, 514-516. Retrieved from https://www.apicareonline.com/index.php/APIC/article/view/273
Issue
Vol.19 No.4(2015): October-December
Section
Case Reports