Suspected Remifentanil-Induced Hyperalgesia in the ICU With Resolution After Opioid Rotation and no Recurrence on Re-Exposure: A Case Report.

Remifentanil-induced hyperalgesia should be considered in ICU patients with worsening pain despite dose escalation. Differentiation from acute opioid tolerance is crucial, as timely opioid rotation may rapidly restore analgesia and allow safe re-exposure to remifentanil without recurrence during later surgery.