Managing Acute Pain in Opioid Tolerant Patients (Acute PAIN‪)‬

Introduction Opioids are widely used in the management of moderate to severe cancer pain as well as for chronic and acute pain (South & Smith 2001). Exposure to opioids can lead to the development of opioid tolerance and the occurrence of opioid induced pain sensitivity (hyperalgesia). The effects of these two phenomena can markedly reduce opioid analgesic efficacy, resulting in significant challenges when managing postoperative pain in this group of patients (Chang et al 2007). There are three main groups of opioid-dependent patients: