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Opioids, allies in musculoskeletal pain management

MOJ Orthopedics & Rheumatology
Ariana Ringer,1 Mout Sebastian,2 Celia Jaimet,3 David Willems,4 Gabriel Aranalde,1 Juan Pablo Ruffino,5 Guillermina Harvey6


Pain management is a fundamental pillar of medical practice. The most commonly controversial drugs used for its treatment are opioids. It is of utmost importance to know how to use them. The aim of this study was to describe the characteristics of treatment with opioids in a third level attention hospital on patients hospitalized inInternal Medicine, during a four months period. A total of 202 patients were evaluated. Most of them, experienced moderate (85/202, 42.08%) to severe (106/202, 52.48%) acute (160/202, 79.21%), somatic nociceptive (93/202, 46.04%) and mixed pain (105/202, 51.98%). In the vast majority of the cases, the opioid indication was adequate to the pain intensity (191/202, 94.55%), and the doctor who indicated the treatment took this into consideration before deciding what type of drug to use (177/202, 87.62%). Opioids were mainly indicated for musculoskeletal postoperative pain (68/202, 33.66%), neoplasms (31/202, 15.35%) and muscular and osteoarticular system disorders (28/202, 13.86%). The most widely used was tramadol (142/202, 70.30%), followed by morphine (48/202, 23.76%) and methadone (10/202, 4.95%). Intervals, rotations and dosis in patients with renal and hepatic dysfunction were, mostly, correct. Rescue therapy and its drawbacks were also analyzed. Antiemetics and cathartic medicaments were prescribed in less than half of the cases (86/202, 42.57% y 90/202, 44.55% respectively). Most frequent side effects were constipation (80/202, 39.60%), nausea (43/202, 21.28%), vomiting (28/202, 13.86%), sedation, drowsiness and lethargy (38/202, 18.81%). Pain must be understood as a multidimensional area and a correct and complete approach must take a wide variety of possibilities into account. 


opioids, rescues, adverse effects, third level attention