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Manage acute pain in opioid-tolerant patients with simple analgesics and adjuvants, along with increased doses of opioids if necessary

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Abstract

Opioid tolerance complicates post-surgical analgesia in many patients, with an increased incidence of psychiatric comorbidity often adding complexity. For the management of acute pain in opioid-tolerant patients, a multimodal approach using simple analgesics, adjuvant agents and short-term increased doses of opioids is recommended, with early involvement of specialist pain services. Paradoxical opioid-induced hyperalgesia, as opposed to acute opioid tolerance, requires compensated dose reduction of the precipitating opioid.

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    Caroline Fenton & Young-A. Heo

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  1. Caroline Fenton
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Contributions

CF searched the literature, prepared the bibliography and wrote the first draft. YAH contributed to the preparation, content, writing and revision of the article.

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Correspondence to Young-A. Heo.

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The preparation of this review was not supported by any external funding. CF and YAH are employed by Adis International Ltd./Springer Nature.

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CF and YAH declare no relevant conflicts of interest.

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Fenton, C., Heo, YA. Manage acute pain in opioid-tolerant patients with simple analgesics and adjuvants, along with increased doses of opioids if necessary. Drugs Ther Perspect 36, 335–340 (2020). https://doi.org/10.1007/s40267-020-00756-4

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