PAIN-CHRONIC PAIN MGM

SUMMARY

1. Fentanyl patch: in a study of patients on long-term opioid therapy, stable long-term pain control was achieved in those patients who finished a 12-month trial (56%) with sustained transdermal fentanyl at doses of approximately 90 mcg/hr. (Ref: Braddom, pg. 956)

2. Adding neuropathic agents: Pregabalin, Gabapentin.

3. Adding simple analgesics according the WHO pain ladder.

4. Adjuvant drugs may be added at any step: antidepressants, anticonvulsants, benzodiazepines, neuroleptics, antihistamines, corticosteroids, calcitonin, and psychostimulants. These supplement analgesia and/or manage side-effects.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.