Suzetrigine Alleviates Severe Chronic Angina for a Patient during thePerioperative Period 

Introduction:

Suzetrigine is a novel sodium channel 1.8 inhibitor thatis marketed as a drug that improves patient pain scoresin the acute setting1-3. While initial studies are promising, overall data islimited until more studies are published ondemonstrated benefit. I present the case report of Suzetrigine incidentallyproviding relief from chronic, refractory angina whengiven in the perioperative period. 

Case Report:

A 58-year-old male on opioids for severe chronic angina presentedfor a cholecystectomy. History of multiple procedures for angina without relief includingcoronary stenting, CABGs, balloon angioplasties, bilateralsympathectomies, and a transmyocardial revascularization. Current medications include a Fentanyl 25 mcg/hr patch,Oxycodone 10 mg TID, Lyrica 75 mg BID, and Ranolazine 1000mg BID. Preoperative meds: Suzetrigine 100 mg, Lyrica 75 mg, andAcetaminophen 975 mg. Intraoperative meds: Fentanyl 150 mcg, Ketamine 20 mg, andMethadone 20 mg. Given his cardiac history, NSAIDs were excluded, and the patientwas admitted for observation overnight. Post-operative meds: Acetaminophen, Suzetrigine, and home medications. Notably, on POD1 the patient reported relief from his angina forthe first time in decades. He had previously tried Acetaminophen,Ketamine and Methadone without benefit, and he attributed hisangina resolution to Suzetrigine. He discharged with Suzetrgine for fourteen days but was unable to continue the medication as it is not yet approved for chronic use. His angina has returned, and he is waiting with his palliative care provider for more studies recommending Suzetrigine for chronic pain management