Please note this guidance is for use in in-patients and is not designed for managing patients with chronic pain
Only the following opioids may be used : Morphine or Oxycodone.
The following patients may be considered for the opioid algorithm:
Patients with poor intravenous access, no oral route established
CAUTION should be exercised and the opioid dose reduced in the following:
Patients with renal impairment - also refer to the Acute Pain Renal Guidelines.
Patients with liver impairment - the opioid may precipitate encephalopathy.
The following patients are NOT SUITABLE for the Opioid Algorithm:
Patients with poor peripheral circulation (altered drug absorption) i.e.severely hypotensive patient, septic patient.
Patients with oedema or poor skin condition at the injection site.
Patients with head injuries.
Patients whose pain is of a chronic non-malignant nature.
All patients should have patient intravenous access (if at all possible).
Nursing staff must be competent in the use of the opioid algorithm and have in-service training on its use.
All ward areas must have Naloxone (400microgram injection) immediately available.
All opioid analgesia must be prescribed on the patient’s drug Kardex
An anti-emetic should also be prescribed on drug Kardex.