Non-Opioids in Pain Management

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There is no ideal analgesic and the most potent drug is not always the best because of its side-effects. Non-opioid analgesics, including the non-steroi­ dal anti-inflammatory drugs and the non-narcotic analgesics, play an im­ portant role in the relief of a wide spectrum of painful conditions, though they vary in efficacy and safety. This book reviews the role which non-opi­ oid analgesics play in the relitff of pain, particularly with regard to post­ operative and cancer pain. Emphasis is placed on the clinical indications for the non-acidic analgesic, dipyrone, and its relative safety in comparison to other non-opioid anlgesics. Michael J. Parnham 9 Introductory remarks Klaus A. Lehmann, Department of Anaesthesiology and Operative Intensive Care, University of Cologne, J osef-Stelzmann-Str. 9, D-50924 Cologne, Germany Opioids are considered to be the most potent analgesics for the manage­ ment of acute and chronic pain. Much progress has been achieved with respect to their general availability in most countries, and health care per­ sonnel have been encouraged to use these drugs more generously in a vari­ ety of pain syndromes, including post-operative or cancer pain. The intro­ duction of new techniques such as Patient-Controlled Analgesia (PCA) or guidelines such as the WHO ladder concept for cancer pain mangement have considerably increased our knowledge of their benefits and prob­ lems.