Abstract
Postoperative pain management for chronically opioid-consuming patients is challenging because of opioid tolerance and the requirements of opioid route conversion and/or switching. We report a case of a patient who was successfully treated with oxycodone by route conversion in the perioperative period. A 49-year-old man with severe pain resulting from a recurrence of clivus chordoma was scheduled for cervical spinal tumor resection. Before surgery, his daily oral oxycodone consumption was approximately 50 mg/day. Opioid route conversion of oral to intravenous oxycodone was performed using an intravenous patient-controlled analgesia device in the postoperative period. Cumulative oxycodone consumption in the 24 h after surgery was equivalent to the preoperative oxycodone daily dose. Satisfactory analgesia was achieved without opioid-related adverse effects throughout the perioperative period. Intravenous oxycodone may be a useful option for perioperative pain management of patients using preoperative oral oxycodone.
