Patients may sleep in spite of severe pain. Comparable noxious stimuli produce the same intensity of pain in different people. Respiratory depression rarely occurs in patients who have been receiving opioids over several months. Patients with a history of substance abuse who require IV opioids should not be given patient controlled analgesia. Elderly patients cannot tolerate strong medications such as opioids for pain.
Children can reliably report the intensity of their pain.
The parents' assessment of the child's pain intensity is not reliable. Following an initial dose of an opioid analgesic, subsequent doses should be adjusted in accordance with the individual patient's response. A placebo can be used to determine if pain is real. In order to be effective, heat and cold should only be applied to the painful area. Although benzodiazepines provide relief of painful muscle spasm, they are not effective analgesics.