A 61 year old male patient, who is being assessed for clinical pain due to grade III obliterating arteriopathy with involvement of the lower limbs. He has been prescribed Durogesic® Matrix 50 μg/h as analgesic treatment for 18 months with acceptable pain control (VAS, 3-4). As rescue medication she is using paracetamol 1 g, (maximum 1 or 2 per day).
She came for an emergency visit to the pain unit because for the last 15 days she has had an increased pain threshold with a certain state of agitation and nervousness. All this occurred after seeing his GP for medication, who prescribed generic transdermal fentanyl 50 μg/h, requiring paracetamol 1 g every 6 h as a rescue, with little pain relief, increasing the VAS to 7-8. After anamnesis with the patient, we again prescribe Durogesic® Matrix 50 μg/h. When the patient was reviewed after 2 weeks, he again presented better pain relief, with VAS of 3-4 again, and the nervousness that he had previously presented disappeared. Currently, 3 months after the last visit, the patient continues with Durogesic® Matrix 50 μg/h and, sporadically, paracetamol 1g.