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Palliative cancer care - pain - Management
How do I manage persistent pain in a non-emergency situation?
- Prescribe analgesia for continuous pain on a regular basis, in addition to as-required analgesia.
- Consider a stepwise approach, using the World Health Organization analgesic ladder. Start at the appropriate point of the analgesic ladder, moving up the ladder when the maximum dose at each step is reached until the person is comfortable. The steps are:
- Non-opioid analgesic: paracetamol and/or nonsteroidal anti-inflammatory drug (mild pain).
- Weak opioid, with or without a non-opioid analgesic (mild-to-moderate pain).
- Strong opioid, with or without a non-opioid analgesic (severe pain).
- At any stage, consider the addition of a non-opioid adjuvant drug.
- Review regularly (consider a telephone call if appropriate), step treatment up or down as necessary, and stop unnecessary medication that has not worked.
In depth
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