TABLE 4-2Pharmacologic Approach to Pain Management Based on Predicted Intensity

Pain IntensityAnalgesic Approach
LowSingle-agent therapy acceptable
NSAIDs, local anesthetic infiltration, or opioid agonist-antagonists (butorphanol, buprenorphine)
ModerateMultimodal analgesia to be considered
NSAIDs in combination with adjuncts such as local anesthetics, opioid agonist-antagonists (buprenorphine), tramadol, α2-agonists, NMDA antagonists
HighMultimodal analgesia recommended
mu-opioid agonists (morphine, hydromorphone, fentanyl, methadone) + one or more of the following: NSAIDs, local anesthetics, α2-agonists, antiepileptic drugs, NMDA antagonists
Advanced analgesic techniques: epidural administration of local anesthetics with or without opioids and constant rate infusions

From: 4, Effective Pain Management

Cover of Recognition and Alleviation of Pain in Laboratory Animals
Recognition and Alleviation of Pain in Laboratory Animals.
National Research Council (US) Committee on Recognition and Alleviation of Pain in Laboratory Animals.
Washington (DC): National Academies Press (US); 2009.
Copyright © 2009, National Academy of Sciences.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.