Advantages and Problems with Non-Opioids in Pain Management

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Effective though they are in the treatment of a wide variety of painful con­ ditions, opioids are not always the most suitable analgesic therapy. Tried and tested non-opioid analgesics are frequently preferable, especially for the treatment of mild to moderate pain, because of their lower incidence of side-effects or more relevant sites of action. "Th more we under tand th etiology of pain th more we know that there ar other drug which might b b tt r than opioid ." (K. Leh­ mann) Many non-opioid drugs are sold in different parts of the world, but not all are equally available or known to the practising physician. The place of dipyrone and other non-opioid analgesics in the treat­ ment of pain was the topic of an associated symposium held on August 19, 1996, during the 8th World Congress on Pain in Vancouver, Canada. The highlights of this Hoechst symposium emphasize that dipyrone and other non-opioid drugs are effective and well tolerated therapies for both acute and chronic pain. 9 Dipyrone in pain management Professor K. Lehmann, M.D. Cologne, Germany Dipyrone and paracetamol represent the small family of non-acidic, non­ opioid analgesics which do not exhibit anti-inflammatory activity. The an­ algesic efficacy of dipyrone is broad and comparable to that of the non­ steroidal anti-inflammatory drugs (NSAIDs) and tramadol. Because dipy­ rone is a weak cyclo-oxygenase inhibitor, its use is not associated with gas­ tric irritation, an important advantage for long-term administration.