Analgesia

Question 1

How do you manage pain?

Answer 1

The WHO analgesic ladder

Step 1: non-opioids

• paracetamol
• NSAIDs

Step 2: weak opioids

• codeine
• dihydrocodeine
• tramadol

Step 3: strong opioids

• morphine
• fentanyl
• oxycodone
• diamorphine

Also:

• local anaesthetic infusions
• patient controlled analgesia
• epidural

Question 2

Side effects of opioids?

Answer 2

Constipation
Confusion
Hallucinations
Nausea, vomiting
Respiratory depression
Addiction

Question 3

Signs of opioid toxicity?

Management?

Answer 3

Respiratory depression
Small pupils
Reduced consciousness

Naloxone