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Post by Admin on Jan 5, 2015 21:37:34 GMT
Oxycodone vs MST Any thoughts any evidence answers on a post card or via the forum preferably.
Thanks
Originally posted by Irene Fitt
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Post by Admin on Jan 5, 2015 21:38:02 GMT
Hi Irene
Our standard analgesic regime is:
Gabapentin 300-600mg as appropriate - stat dose pre and postop TAP blocks at end of procedure (repeated day 1 or 2 postop if required) Paracetamol QDS Regular NSAID as appropriate 4 hrly sublingual ketamine for 48 hrs PRN Oramorph or OxyNorm
All pts referred to pain team from pre-assessment and seen by them from postop day 1 onwards as long as needed.
Around 20% of our colorectal pts will have some Oxycodone or MST for a couple of days if they are unable to manage on the routine and short-acting PRN analgesic regime. (We don't use epidurals or PCAs). The In-Patient Pain Team see everybody and they base their decision on what to prescribe on the effectiveness of the PRN Oramorph or OxyNorm. Of those 20%, I had a look back and the distribution of pts having either Oxycodone or MST seems to be 50/50. Jayne Mundy Enhanced Recovery Programme Nurse Facilitator Western Sussex Hospitals NHS Trust - Worthing Hospital
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Post by Admin on Jan 5, 2015 21:38:20 GMT
Oxycodone is known to have a better side-affect profile (particularly with regard to less nausea and vomiting) than MST, as it is a synthetic opioid, as well as being more efficacious from a pain point of view.
Unless contra-indicated, all our hip and knee replacement patients receive 10mg Oxycodone MR at 20.00hrs on Day 0 and at 08.00hrs and 20.00hrs on Day 1. Oxynorm liquid 10mg is used for PRN breakthrough analgesia throughout the patients stay (if this breakthrough requirement becomes very frequent, then we commence patients on codeine QDS).
That said, for those already on MST (and/or oramorph)it is preferable to revert to their existing regimen by Day 2 at the latest.
We also provide analgesia as part of our pre-med (paracetamol and gabapentin), along with dexamethasone and omeprazole.
I could talk all day about pain (being a former Pain CNS), but I'll stop there at the risk of boring you all! Glenn Lake Chichester & Worthing Enhanced Recovery Programme (CWERP) Nurse Facilitator
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Post by Admin on Jan 5, 2015 21:41:18 GMT
NSAID's after colorectal surgery posted Aug 11, 2014 by irene.fitt As we know lots of discussion re leaks,just wanted to know what the practice was in your hospitals ?
Thanks
Irene
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Post by Admin on Jan 5, 2015 21:41:35 GMT
Hi
We use Ibuprofen with PPI cover, unless contra-indicated, usually just while an in-patient. Or if the patient is already taking an NSAID they just continue on the same. Jayne Mundy Enhanced Recovery Programme Nurse Facilitator Western Sussex Hospitals NHS Trust - Worthing Hospital
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Post by pwsch23 on Apr 1, 2016 9:34:09 GMT
Thanks for sharing this post on Pain management. Being an assistant in a chiropractor in Mississauga Ontario clinic, I highly suggest getting chiropractic to overcome the pain. It is a natural TCM therapy without any side effects.
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