อนุทิน 92023

Escalating opioid.

Opioid naive with mod-sev pain -> giving Morphine 2- 5 mg IV

Re-evaluate 15 min ( - this is the peak effect, however, pt should show some relieve at 5 min after prescribeed)

Escalating dose if not feel better

mild to mod     : 25-50%
severe             : 50-100 %
Percentage reduce for elder /poor renal or liver function.

eg. 5 mg IV --> pt still show crying, highly pain : 5+5 = 10

http://www.eperc.mcw.edu/fastFact/ff_20.htm

" Sponge concept -- pain like a sponge, as large it is, as wide margine of safty from opioid use." (prof.Pantilat)