What is the rationale for combining opioid and
nonopioid analgesics in the treatment of moderate
pain?
1. Becker, D. E., & Phero, J. C. (2005). Drug therapy in dental practice: nonopioid and opioid analgesics. Anesthesia progress, 52(4), 140-149.
2. Chang, A. K., Bijur, P. E., Esses, D., Barnaby, D. P., & Baer, J. (2017). Effect of a single dose of oral opioid and nonopioid analgesics on acute extremity pain in the emergency department: a randomized clinical trial. Jama, 318(17), 1661-1667.
the aim of it is to downgrade the patients pain according to the WHO pain ladder.
Utoor,
We refer to this practice as multimodal pain management. Pain is a complex, multi-receptor process. There are peripheral as well as central processes that are involved in pain transmission.
https://jamanetwork.com/journals/jamasurgery/fullarticle/2629299
https://moodle.med.lu.se/pluginfile.php/55480/mod_resource/content/3/Sm%C3%A4rta_Narinder_2016.pdf
https://www.jpain.org/article/S1526-5900%2815%2900995-5/fulltext
Article Recent advances in acute pain management: Understanding the ...
As @Christopher explained so well, I will just add that such approach is very useful in our Pediatric ICU settings.
May I suggest that the severity of pain has little diagnostic value, and the first question should be "Is this acute or chronic pain?" and the next question should be "What tissue type is damaged?" Various tissue injuries respond better to non-opioid medication than to narcotics. Please see the attached article. Nelson Hendler, MD, MS former assistant professor of neurosurgery. Johns Hopkins University School of Medicine, past president-American Academy of Pain Management.
LOS NO OPIOIDES SE UTILIZAN COMO TRATAMIENTO DE "RESCATE" O APOYO A LOS OPIÁCEOS...DE LOS QUE NO SE PUEDEN USAR MÁS, SALVO EN SU MOMENTO PAUTADO, PORQUE LOS RECEPTORES CEREBRALES PARA DICHOS OPIACEOS YA ESTÁN "BLOQUEADOS" HASTA EL MOMENTO DE LA NUEVA INGESTA, POR LO QUE INGERIR MÁS ANTES ¡NO VALDRÍA PARA NADA!...LO QUE NO SUCEDERÍA, P. EJ., CON AINES...DE AHÍ EL QUE SE UTILICEN COMO DE RESCATE, COADYUVANTES Y "REFORZADORES" DE LOS OPIOIDES.
UN CORDIAL SALUDO
Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care White Paper 12.15. 2017
- December 2017
- DOI:
- 10.13140/RG.2.2.23111.80802/1
NON-OPIOIDS ARE USED AS Treatment OF "RESCATE" OR SUPPORT TO OPIOIDS... OF WHICH CANNOT BE USED MORE, EXCEPT AT YOUR STANDARD TIME, BECAUSE THE BRAIN RECEIVERS FOR SUCH OPIACEOS ARE ALREADY "LOCKED" UNTIL THE TIME OF THE NEW INGESTA, SO INGERING MORE!... BEFORE WHAT WOULDN'T HAPPEN,
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