Pain Control: Opiods

I will go over some general information regarding opioid use for analgesia. In subsequent entries I will go over different opioid use for 1) mild to moderate pain, 2) moderate to severe pain, and 3) severe pain. I would say for my practice most patients fall into the moderate to severe pain, but for a short period of time.


Key Points:

  • No ceiling effect (as a general statement this means the larger the dose, the larger the effect)
  • Tolerance can develop with chronic use
  • Overuse can lead to respiratory depression or seizures

Mild to moderate pain: codeine or tramadol
Moderate to severe pain: hydrocodone, oxycodone, hydromorphone
Severe pain: morphine, codeine, methadone

**Some of these can crossover between categories based on dosage.

Source: Handbook of Neurosurgery, Greenberg 6th ed

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