Mba UC, Onyebueke G, Okwesili OR, Enyanwuma IE, Okorie GM, Ohayi SR, Ugwu IC, Ezeme MS, Okenwa WO. Tissue Necrosis: A Burden of
Pentazocine Abuse in South East Nigeria.
J West Afr Coll Surg 2024;
14:159-165. [PMID:
38562381 PMCID:
PMC10980324 DOI:
10.4103/jwas.jwas_90_23]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 09/10/2023] [Indexed: 04/04/2024]
Abstract
Background
Tissue necrosis from pentazocine abuse is becoming a burden in our environment. Pentazocine is an opioid of the benzomorphan class. It is commonly used for post-traumatic and postoperative pain and vaso-occlusive pain of sickle cell disease (SCD). Its prolonged use can lead to addiction and may result in severe injection site necrosis, often worsened by infection due to a lack of aseptic principles during administration. Although pentazocine is a controlled drug in our environment, it is readily available.
Objectives
To review patients with tissue necrosis from pentazocine injection, share the challenges in their management, and proffer solutions.
Materials and Methods
Clinical summaries of patients with tissue necrosis and ulcers due to pentazocine addiction were reviewed.
Results
Twenty-five patients, comprising nine females and 16 males aged 22-61 years, were recorded. Twenty had SCD, while five had other underlying conditions. The duration of abuse was 1-16 years, while the average maximum daily dose was 348.75 ± 346.04 mg. Most patients used multiple sites for injection. Lesions included abscesses, tissue necrosis with ulcers, lymphoedema, exposed necrotic bones, and osteomyelitis. Most had multidisciplinary care. The outcome of wound care was good in two. Three had major limb amputations, four died, three signed against medical advice, six were still receiving care while seven were lost to follow-up. None was completely weaned from the drug at the time of this report.
Conclusion
Rising cases of tissue necrosis from pentazocine abuse are disturbing. Treatment is frustrating. Concerted efforts at prevention should be made to stem the tide.
Collapse