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Any questions: Combination approach to pain relief

BMJ 1997; 315 doi: (Published 13 December 1997) Cite this as: BMJ 1997;315:j
  1. A S C Rice, senior lecturer and honorary consultant in pain relief
  1. London

    What analgesia could be used for a patient who is hypersensitive to opiates, which include morphine, pethidine, and oral codeine? The patient feels very unwell and develops low blood pressure. What analgesia should be used in the event of an accident or postoperatively? Is there a case for a challenge test when the patient is well?

    I will limit my response to the management of acute pain. As a consequence of an intercollegiate report (and other guidelines) most acute surgical hospitals now offer an acute pain service led by a consultant anaesthetist.1 2 The first action might be to contact the local pain service, which should be …

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