Treatment of Adhesive Arachnoiditis Requiring Potent Long-Acting Opioid Pain Management
This protocol addresses pain management in Adhesive arachnoiditis where adequate control requires escalation to a potent opioid regimen, including structured provision for acute severe pain flares.
Treatment Approach
The protocol centers on transitioning to a potent long-acting opioid preparation, with a separate provision for managing acute severe pain flares through an appropriately selected short-acting agent.
Specific agents, formulations, dosing, and routes are detailed in the full structured protocol below.
References
- Failure of LDN or Low Dose Opioid to control Pain: Switch to a potent long-acting opioid. Options: fentanyl patch or a morphine or oxycodone long-acting preparation.
- Severe Pain Flares: Short acting hydromorphone, oral 2.0 to 8.0 mg. For optimal relief, use ultra potent hydromorphone injectable (50 mg/ml). Five (5.0) mg is only 0.1 cc which is injected subcutaneously under the skin (Source: Anazao Laboratories, Tampa, Florida).
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