Principles of medication for pain relief

  1.Oral administration: Oral administration of various analgesic drugs, especially strong opioids (such as morphine and its syrup), can obviously reduce the mental dependence and physical dependence of patients after using the drugs.  2.Timely dosing: pain medication for cancer pain must be given regularly and on time, rather than as soon as there is pain.  3.Dosing in steps: This is the treatment plan for cancer pain recommended by the World Health Organization. In case of mild pain, non-opioid drugs (commonly used antipyretic and analgesic drugs) and adjuvant drugs are used; in case of moderate pain, weak opioid drugs, non-opioid drugs and adjuvant drugs are used; in case of severe pain, strong opioid drugs, non-opioid drugs and adjuvant drugs are used.  4. Individualization of medication: the dose of pain medication should adhere to the principle of small to large. The best dose is the one that can significantly reduce pain or even disappear. The dose should not be too strict, otherwise it is difficult to achieve satisfactory pain relief effect.  The choice of pain medication 1, mild pain: according to the principles of pain medication, aspirin can be used, 25-60 mg each time; or paracetamol, 0.25-0.5 g each time; or go to pain tablets, 1-2 tablets each time. In addition, optional ibuprofen (fenbuterol), propoxyphene tablets, etc.  2, moderate pain: can use codeine, 30-60 mg each time; or aminogest, 1 to 2 tablets each time; or prednisone, 30 to 90 mg each time; or tramadol capsules (pain Lik), 50 to 100 mg each time. In addition, you can also use propoxyphene tablets, high-potassium tablets and other pain relief drugs.  3, severe pain: general painkillers are more difficult to work. Morphine tablets can be used, 5-30 mg each time; or pethidine, 50-100 mg each time. In addition, drugs such as guanxi, aniduo and buprenorphine can also be used.  In addition to the above drugs, for patients with advanced cancer, the World Health Organization and the Ministry of Health of China also recommend the use of oral controlled-release tablets Methocarbamol, Mefecam, Lutai and other pain-relieving drugs.  Issues to be noted 1. Analgesic drugs should be given at the right time. It is generally believed that cancer pain patients should start to receive analgesic drugs only a few weeks before their death or in the last two months of life. However, many cancer patients actually have intermittent or persistent intractable pain at an earlier stage, which is often unbearable for patients. Therefore, new research suggests that cancer patients with pain should be treated decisively with a variety of therapeutic measures to provide mental and physical relief. Pain can cause rapid deterioration of the patient’s general condition and low immune function, which is also very unfavorable to the treatment of cancer if not eliminated in time.  2. Patients in all stages and all kinds of pain should be selected according to the principle of pain relief. When patients have different degrees of pain, analgesic drugs must be selected according to the principle of non-opioid to weak opioid to strong opioid. The dose of medication should also start from a small dose, and then gradually increase the dose according to the pain control situation. Do not use drugs indiscriminately, otherwise, it will be difficult for analgesic drugs to be effective at a later stage.  3. Choose the appropriate route of drug delivery. For the vast majority of cancer pain patients, oral analgesics can achieve good results. For some advanced patients who cannot take drugs orally, they should choose sublingual analgesics or subcutaneous or intravenous analgesics.  4.Prevent drug tolerance. Patients who use analgesic drugs for a long time because of chronic pain will have drug tolerance problems. At the same time, the longer the medication is used, the larger the dose of medication required, and various adverse reactions will follow. The methods to prevent or reduce drug tolerance include: applying adjuvant drugs as much as possible to enhance the analgesic effect; alternately applying different types of analgesic drugs instead of using one drug alone; gradually adjusting the drug dose after the patient’s pain is reduced, and extending the interval of drug use; and cooperating with other analgesic methods for treatment.  In the process of cancer pain treatment, it is very important to choose what drugs, how much dose and how long to use. Therefore, drugs should be selected under the guidance of doctors.