Combination of Low Dose Ketamine, Paracetamol, and Tramadol for Opioid Induces Hyperalgesia in Lung Cancer with Intra Abdominal Metastases

Background: Opioid induced hyperalgesia or OIH is one of exaggerated response to pain secondary to using of the opioid itself. High dosage of opioid in long term (days to weeks) relate to increased OIH occurrence.Case: Female, 58 yrs, BMI 17.77, complained severe abdominal pain with NRS 8/10. Patien...

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Main Authors: Simbolon, Boyke Marthin (Author), Sinaga, Mual Kristian (Author)
Other Authors: a person (Contributor)
Format: EJournal Article
Published: Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif, 2020-07-01.
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LEADER 02768 am a22003133u 4500
001 JAI_UNDIP_28427_17961
042 |a dc 
100 1 0 |a Simbolon, Boyke Marthin  |e author 
100 1 0 |a a person  |e contributor 
700 1 0 |a Sinaga, Mual Kristian  |e author 
245 0 0 |a Combination of Low Dose Ketamine, Paracetamol, and Tramadol for Opioid Induces Hyperalgesia in Lung Cancer with Intra Abdominal Metastases 
260 |b Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif,   |c 2020-07-01. 
500 |a https://ejournal.undip.ac.id/index.php/janesti/article/view/28427 
520 |a Background: Opioid induced hyperalgesia or OIH is one of exaggerated response to pain secondary to using of the opioid itself. High dosage of opioid in long term (days to weeks) relate to increased OIH occurrence.Case: Female, 58 yrs, BMI 17.77, complained severe abdominal pain with NRS 8/10. Patient suffered from lung cancer stage 3 with intra abdominal metastases. Previously patient had received analgesic paracetamol 1gr TID, dexketoprofen 25mg TID, parecoxib 40mg OD, morphine 10mg BD and fentanyl patch 50 µg. Then fentanyl was given 25 µg IV twice with interval of 15 minutes. Patient still complained for pain and eventually pain severity increased to NRS 10/10. Afterwards patient was given low dose ketamin 0.1mg/kg slow IV push, paracetamol 1gr IV, and tramadol 50mg IV. After 15 minutes observation, pain decreased to NRS 5/10.Discussion: Decreasing total dose of opioid consumed may decresed OIH. It may be performed by improving analgesia by using combination of analgesic and intervention strategy.Conclusion: combination of low dose ketamine (0.1mg/kg), paracetamol, and tramadol may be benefit for patient with opioid induces hyperalgesia in lung cancer stage 3 with intra abdominal metastases. 
540 |a Copyright (c) 2020 JAI (Jurnal Anestesiologi Indonesia) 
546 |a eng 
690 |a anasthesiology and pain management 
690 |a abdominal metastases; abdominal pain; low dose ketamine; numeric rating scale; opioid induced hyperalgesia 
655 7 |a info:eu-repo/semantics/article  |2 local 
655 7 |a info:eu-repo/semantics/publishedVersion  |2 local 
655 7 |2 local 
655 7 |2 local 
786 0 |n JAI (Jurnal Anestesiologi Indonesia); Vol 12, No 2 (2020): Jurnal Anestesiologi Indonesia; 30-36 
786 0 |n 2089-970X 
786 0 |n 2337-5124 
787 0 |n https://ejournal.undip.ac.id/index.php/janesti/article/view/28427/17961 
787 0 |n https://ejournal.undip.ac.id/index.php/janesti/article/downloadSuppFile/28427/4868 
856 4 1 |u https://ejournal.undip.ac.id/index.php/janesti/article/view/28427/17961  |z Get Fulltext 
856 4 1 |u https://ejournal.undip.ac.id/index.php/janesti/article/downloadSuppFile/28427/4868  |z Get Fulltext