ABSTRACT
INTRODUCTION One of the most difficult challenges facing even the most seasoned anesthesiologist is the adequate treatment of pain in opioid-tolerant patients, who often appear to be immune to the usual effects of opioids. These opioid-resistant individuals may experience severe and escalating pain in the postoperative period, requiring above average dosing of opioids. Despite the decreased analgesic effect of opioids in these opioid-tolerant individuals, tolerance to the adverse effects of opioids may be incomplete, posing risks of respiratory compromise. However, with proper patient preparation, education, and the use of alternative therapies, a smoother analgesic course may be realized.
