- A multimodal analgesic approach or pharmacologic intervention includes non-opioid analgesics such as non-steroidal anti-inflammatory drugs [NSAIDs]; opioids (e.g., morphine) and adjuvant medications (e.g., antidepressants, anticonvulsants, anaesthetic agents) that act through different mechanisms to modulate a person’s pain
- To maximize efficacy and minimize the adverse effects of a multimodal analgesic approach nurses should use the following principles to guide practice:
- Use the most efficacious and least invasive way to administer analgesics.
- Consider a multimodal analgesic approach to pain management:
- Use non-opioids to manage mild to moderate pain (acetaminophen or NSAIDs);
- Use opioids in combination with non-opioids to manage moderate to severe pain; and
- Use advanced modalities such as patient-controlled analgesia [PCA], epidural, intrathecal, and nerve blocks, which may provide superior analgesia to manage persistent, non-malignant or cancer pain and acute pain experienced from major surgical procedures or injury
- Advocate for the most effective dosing schedule, considering the medication(s) duration of onset, effect(s) and half-life. The optimal analgesia dose is one that effectively relieves pain with minimum adverse effects.
- Recognize potential contraindications, such as co-morbidities or drug-drug interactions, related to the person’s clinical condition.
- Titrate any pain medications to achieve the maximum effectiveness whilst minimizing adverse effects.
- Anticipate and manage the adverse effects from pharmacologic interventions.
- Consider consulting the interprofessional team or pain-management experts for complex pain situations.
Assessment and Management of Pain - 3rd Edition
Point of Care Resources