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Hospital-based Palliative Care TeamsThe Hospital/Hospice Interface$

R. J. Dunlop and J. M. Hockley

Print publication date: 1998

Print ISBN-13: 9780192629807

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780192629807.001.0001

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(p.158) Appendix 3 Sample guidelines on the use of analgesics for the patient with advanced cancer

(p.158) Appendix 3 Sample guidelines on the use of analgesics for the patient with advanced cancer

Source:
Hospital-based Palliative Care Teams
Publisher:
Oxford University Press

The following information details the general principles and guidelines useful in the choice of analgesics for pain in patients with advanced cancer. It is essential that before any analgesics are chosen a detailed assessment of the patient's pain is performed. This must include details on: the exact site of the pain, the possible cause of the pain, the type of pain, and its severity. The World Health Organisation recommends that to achieve optimum pain relief analgesia must be given as follows:

  • by the mouth

  • by the clock (regularly and not on a PRN basis)

  • by the ladder (see below)

Appendix 3 Sample guidelines on the use of analgesics for the patient with advanced cancer

Notes:

1. Pain unrelieved despite strong opioids

Appendix 3 Sample guidelines on the use of analgesics for the patient with advanced cancer

*** Please see overleaf for further details on the use of adjuvant therapies and co-analgesics ***

(p.159) Adjuvant therapies and co-analgesics for pain management

The choice of co-analgesic depends on the likely cause of the pain, making a detailed re-assessment of the patient's pain crucial, Below are some of the common pains that do not always respond totally to the use of opioids, and suggestions for their management.

Appendix 3 Sample guidelines on the use of analgesics for the patient with advanced cancer

(Chemotherapy Services Committee and Palliative Care Team-November 1996)

WESTERN GENERAL HOSPITAL NHS TRUST, Edinburgh

(p.160)