Opiates & Analgesics
Opioids are potent analgesics used for acute and chronic pain, but they carry significant risks including dependency, tolerance, and side effects.
Types of Analgesics:
Non-opioid analgesics: Paracetamol (acetaminophen) – first-line for mild pain.
Opioid analgesics: Codeine, Tramadol, Morphine, Oxycodone, Fentanyl.
Mechanism:
Opioids bind to mu, delta, and kappa receptors in the CNS to modulate pain perception.
Orthopaedic Use:
Post-operative pain (especially moderate-to-severe).
Severe musculoskeletal trauma.
Cancer-related bone pain.
Risks & Side Effects:
Respiratory depression
Constipation, nausea, vomiting
Sedation and dizziness
Tolerance and physical dependence
Opioid-induced hyperalgesia (OIH)
Risk of misuse or addiction
Clinical Tips:
Use multimodal analgesia (combine with NSAIDs or acetaminophen).
Start with lowest effective dose and shortest duration.
Monitor closely in elderly and renal impairment.
Consider regional anaesthesia when possible to reduce opioid need.