These shorter-acting narcotics do provide good coverage for breakthrough pain, however. In the clinical management of intractable long-standing pain , there is no specific dose of opiate, and no ceiling above which further dosing is inadvisable. The specific agent chosen is less important than the principal that maintaining a therapeutic blood level of opiate is the most appropriate treatment for long-standing pain. In order to avoid overdosing, the sustained-release opiate should be dosed for analgesia with the patient at rest. In this context it is important for the care-provider to remember that opiates should be given in escalating doses until the desired effect is achieved.
Side effects are the only limiting factor.
In the clinical management of intractable long-standing pain , there is no specific dose of opiate, and no ceiling above which further dosing is inadvisable. The specific agent chosen is less important than the principal that maintaining a therapeutic blood level of opiate is the most appropriate treatment for long-standing pain. In order to avoid overdosing, the sustained-release opiate should be dosed for analgesia with the patient at rest. Neuropathic pain may be resistant to opiate dosing alone. For severe neuropathies, the dose of opiate should be titrated upwards, but adjuvant drugs should be used concomitantly.