Background: Pain, not responsive to opioid analgesics, remains a problem for patients with
chronic and cancer pain as well as their families, and clinicians. Opioid antagonists have various
uses in pain and palliative care. Their use in the reversal of tolerance and hyperalgesia
remains at the basic science level and has limited clinical exposure.
Objective: To improve symptom control and quality of life in patients with pain not responsive
to opioid analgesics.
Design: Present three cases in which patients have undergone administration of opioid antagonists
for the purpose of analgesia.
Methods: Patients on opioids analgesics received parenteral opioid antagonist, naloxone.
Complete withdrawal under a sedative or conscious sedation was allowed and then the opioid
at smaller doses was restarted and analgesia was observed.
Results: All patients had improved analgesia on a significantly lower dose of opioid analgesics.
Conclusions: Only three patients who have received this procedure were presented yet all
have responded positively to this procedure. Further research is needed to elucidate the mechanism
and clinical relevance in the acute use of opioid antagonists.
