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Electronic Letters to:

Correspondence:
N. M. Gajraj and K. H. Simpson
Opioids for non-cancer pain
Br. J. Anaesth. 2004; 93: 149 [Full text] [PDF]
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Electronic letters published:

[Read E-letter] Overdose due to Transdermal Buprenorphine analgesia for non cancerous pain
Rajaraman Durai, Ramya Venkatraman, Paediatric intensive care unit, Guy’s Hospital, London   (1 February 2005)

Overdose due to Transdermal Buprenorphine analgesia for non cancerous pain 1 February 2005
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Rajaraman Durai
Department of Surgery, Royal Free Hospital, London;,
Ramya Venkatraman, Paediatric intensive care unit, Guy’s Hospital, London

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Re: Overdose due to Transdermal Buprenorphine analgesia for non cancerous pain

2 February 2005 Re: British Journal of Anesthesia, 2004, Vol. 93, No. 1 149 Opioids for non-cancer pain by N. M. Gajraj and K. H. Simpson Overdose due to Transdermal Buprenorphine analgesia for non cancerous pain

Dear Editor,

Transdermal analgesia is increasingly used for controlling pain due to cancer as well as non cancerous conditions. Overdose from such transdermal analgesia is not known. We had a 60 years old patient who received a buprenorphine patch for 2 days to control his ischemic limb pain. He did not receive any other opioids. Suddenly he became unconscious with a Glasgow Coma Score of 3 for no obvious reason. His pulse was 100, Temperature –36.8 .His Blood pressure dropped from 120 to 96 and remained low despite vigorous resuscitation. Examination of cardiorespiratory system and abdomen did not show any pathology to explain his condition. His pupils were pinpoint. He had normal reflexes and flexor plantar. His blood tests including FBC, U&E, Sugar as well as blood gases were within normal limits. ECG was normal. He responded well to Naloxone 400mcg Intravenous injection .His consciousness and BP returned back to normal. We hope this formation may be of some help to others in the future. So if some one becomes unconscious, if he has a transdermal opioid patch one should think of opioid toxicity. Rajaraman Durai, Department of Surgery, Royal Free Hospital, London Ramya Venkatraman, Paediatric intensive care unit, Guy’s Hospital, London