ABSTRACT
Intravenous oxycodeine hydrochloride and intramuscular morphine are strong and effective analgesics. The rationale for preferring PCA is that it has been shown to provide a superior background of analgesia, with fewer episodes of breakthrough pain. Parental opioid administration is preferred in patients who are less suitable for PCA, i.e. those unable to understand instructions, those under sedation and those with vision impairment or mobility/coordination issues. Paracetamol and diclofenac are simple analgesics which you are told have not relieved the patient’s pain. These drugs may be appropriate to use in conjunction with a PCA system or other morphine analgesia, although candidates must be aware that PR drugs should be strictly avoided in patients with a recent low rectal resection.
