Epidural analgesia for acute ischemic pain after intra-arterial zolpidem injection in opioid-addicted patient-A case report

Irena Krajina Kmoniček; Slavica Kvolik; Kresimir Pinotić; Tomislav Ištvanić; Boris Mraovic; Ksenija Marjanovic

doi:10.1002/ccr3.3445

Epidural analgesia for acute ischemic pain after intra-arterial zolpidem injection in opioid-addicted patient-A case report

Clin Case Rep. 2020 Oct 27;8(12):3445-3449. doi: 10.1002/ccr3.3445. eCollection 2020 Dec.

Authors

Irena Krajina Kmoniček¹, Slavica Kvolik^{1

2}, Kresimir Pinotić^{2

3}, Tomislav Ištvanić^{2

3}, Boris Mraovic⁴, Ksenija Marjanovic^{2

5}

Affiliations

¹ Department of Anesthesiology Osijek University Hospital Osijek Croatia.
² Faculty of Medicine Josip Juraj Strossmayer University of Osijek Osijek Croatia.
³ Department of Surgery Osijek University Hospital Osijek Croatia.
⁴ Department of Anesthesiology & Perioperative Medicine School of Medicine University of Missouri Columbia MO USA.
⁵ Department of Pathology Osijek University Hospital Osijek Croatia.

Abstract

A patient taking opioid maintenance therapy unintentionally injected dissolved zolpidem pills into the femoral artery and suffered acute limb ischemia. High amounts of opioids with supplemental therapies were inefficient for intractable ischemic pain, suggesting the presence of opioid-induced hyperalgesia (OIH). Epidural analgesia efficiently relieved pain and symptoms of OIH.

Keywords: acute medicine; anesthesia; pharmacology; vascular surgery.

Publication types

Case Reports