Pain relief for the opioid intolerant patient

One of the suggestions regarding the publication of the website was to have a “recent events” section within the website in the format of a blog. Here it is.

My recent reading has been around the subject of analgesia (pain-relief) for the opioid-intolerant patient. That is, how to formulate postoperative analgesia plans for patients who cannot take morphine or morphine-like medications. Usually, the intolerance is linked to nausea and vomiting.

The consensus (the actual evidence is not great) is that a combination of drug and non-drug approaches help. That is the way all pain-relief plans are formulated. As far as medications go: changing routes of administration, changing to controlled release preparations and choosing medications from different classes are all reasonable approaches.

It is probably unrealistic to promise an specific outcome in terms of pain relief after an operation or procedure. The only guarantees should be that the basis of recommendations will be good evidence (where that exists) and safe practice. The other aims should be to continue to be available to offer options that are reasonable and to see issues through as they arise.