PainSA is a chapter of the International Association for the Study of Pain. Our mission is to improve all aspects of pain management in Southern Africa.

The Use of Very-Low-Dose Methadone for Palliative Pain Control and the Prevention of Opioid Hyperalgesia

Opioid dose escalation may cause hyperalgesia, mediated by the N-methyl-D-aspartate (NMDA) pathway. Methadone is an atypical opioid that inhibits hyperalgesia through NMDA blockade, especially at low doses. 

Objective: To evaluate the efficacy of using very-low-dose methadone as the sole long-acting opioid agent in a hospice practice.

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