Anestesia e Pesquisa Clínica
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Opioid Resistant Pain Successfully Managed with Magnesium, Lidocaine and Ketorolac in the Post-Anesthesia Care Unit: A Case Series

Brandon Alan Van Noord, Jack Berger and Arash Motamed

Opioid resistant pain in the Post-Anesthesia Care Unit is challenging and often poorly controlled. Post-operative pain greater than 7/10 pain despite 8 mg of IV morphine or equivalent was defined as opioid resistant pain. This case series reports five consecutive patients with opiate resistant pain who were successfully managed with a one-time concomitant IV bolus of 1 gm magnesium, 100 mg lidocaine, and 15 mg ketorolac. The patients were continuously monitored in the PACU. This novel combination produced greater than 50 percent mean pain score reduction with no adverse effects.