Table 153 World Health Organization analgesic ladder

Level of pain

Analgesic requirement

1. Mild pain

2. Persistent or increasing pain

Nonopioid

Opioid for mild to moderate pain

± Adjuvant

±Nonopioid ± Adjuvant

3. Cancer pain

Opioid for moderate to severe pain

±Nonopioid ±Adjuvant sidered. As a rule, SCS is considered to be less invasive or more conservative than chronic intraspinal drug administration and may be more effective for neuropathic pains. In the past SCS was considered for peripheral and some central neuropathic pains and drug administration systems (DASs) for opioid-responsive nociceptive pain. As more novel intrathecal analgesics have appeared that are effective for neuropathic pain and dual-lead SCS systems have been used for more no-ciceptive pain, the strict selection criteria have become blurred.24

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Essentials of Human Physiology

Essentials of Human Physiology

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