As the treatment of chronic non-cancer pain gradually increases, clinicians have more opportunities to encounter opioid prescription. However, guidelines for prescribing opioids for chronic non-cancer pain have never been published in Korea. The present guidelines were prepared by reviewing various research data. In cases in which the data were insufficient, recommendations were presented following discussion among experts affiliated with the Opioids Research Group in the Korean Pain Society. The present guidelines may need to be continuously revised and amended as more clinical evidence is acquired.
Analgesics, Opioid* ; Korea* ; Prescriptions

No abstract available.
Analgesics, Opioid* ; Korea*

No abstract available.
Analgesics, Opioid* ; Dexmedetomidine* ; Neuralgia*

Opioid aberrant behavior is an emerging problem as strong opioid is increasingly used to alleviate cancer pain in patients with cancer. Although the treatment of opioid addiction and physical dependence for non-cancer pain is well known, few studies have been conducted with cancer patients, particularly in the Korean population. Presented here are ten cases of cancer patients who were physically dependent on strong opioid and successfully treated with a partial mu-opioid receptor agonist, buprenorphine. This is the first report showing the efficacy of transdermal buprenorphine as a treatment for physical dependence on opioid medication in cancer patients.
Analgesics, Opioid ; Buprenorphine* ; Humans ; Opioid-Related Disorders

Opioids are the most effective analgesics for cancer pain treatments. But the ineffective treatment of cancer pain is often related to insufficient knowledge of opioids and fear of the addiction along with the side effects. To achieve effective treatment of cancer pain with opioids, we need a careful assessment of pain, proper use of opioids and regular review of the effectiveness of prescribed opioids. Basic principles of opioids therapy in cancer pain are 1. Oral opioids (or transdermal) if possible; 2. Combination of long-acting opioids for constant pain with short-acting opioids for breakthrough pain; 3. "Opioids rotation"in poor analgesia and significant side effects with the calculations of the morphine equivalent daily dose (MEDD) 4. Initiation of prophylactic treatment for constipation and nausea. In this review, I will describe the essential aspects of opioids therapy, pharmacology, rotation, properties of the individual opioids, and management of common side effects.
Analgesia ; Analgesics ; Analgesics, Opioid ; Constipation ; Morphine ; Nausea

BACKGROUND: Opioids can produce potent antinociceptive effects by interacting with local opioid receptors in inflamed peripheral tissue. However, reports on pain relief with intra-articular morphine after arthroscopic knee operations are conflicting. In this study we examined the analgesic effects of the intraarticular administration of morphine after knee surgery. METHODS: In a double-blind, randomized trial, we studied 26 patients who had received one of two injections at the end of surgery. The patients in group M(n=11) received 3 mg of morphine intraarticularly; those in group P(n=15), saline 20 ml intraarticularly as a placebo. RESULTS: Patients in the morphine group had significantly lower pain scores throughout the 24-h postoperative period compared with those in the placebo group(P<0.05). There was less requirement for supplementary analgesics in the morphine group. CONCLUSIONS: Low doses of intraarticular morphine can significantly reduce pain after knee surgery without any systemic side effect.
Analgesics ; Analgesics, Opioid ; Humans ; Knee* ; Morphine* ; Postoperative Period ; Receptors, Opioid

Introduction: The efficacy of opioids for cancer pain has been proven. However, opioids specifically Morphine usage for cancer pain relief among resident physicians is still low. One of the major contributing factors to inadequate pain control is the healthcare provider’s lack of knowledge about cancer and non- cancer pain. Hence, this study was done to assess and identify the level of knowledge and practice of the physicians on opioid use for chronic pain. Methods: A validated questionnaire on knowledge and practice was given to the resident physicians in training in 2 government hospitals in region 1 namely Ilocos Training and Regional Medical Center (ITRMC) and Mariano Marcos Memorial Hospital and Medical Center (MMMH&MC). Descriptive statistics were used to analyze demographics, overall knowledge and practice on morphine use among resident physicians and inferential statistics were used to test for comparative study between the two different institutions. Results: A total of 83 respondents, 50 from ITRMC and 33 from MMMH&MC, 56 of which were females and 27 were males showed that the overall knowledge of resident physicians elucidates that out of 11 questions asked, they acquired half normative or mean scores of 6.44 in ITRMC and 5.61 in MMMH&MC, respectively. Resident physicians in both government hospitals do not use or give morphine use acquiring more than half, 27 out of 50 or 54.0% in ITRMC and 23 out of 29 or 79.3% in MMMH&MC. Conclusion The results showed that the level of understanding and knowledge on morphine use among resident physicians from both government hospitals is inadequate. Thus, their limited knowledge hinders the utilization of morphine use.
Knowledge ; Analgesics, Opioid ; Cancer Pain

Opioid-induced rigidity is a potentially life-threatening complication that can occur after treatment with large doses of opioids, but with early recognition it can be treated effectively with naloxone or with muscle relaxants. Regarding its onset time, there have been few case reports that have described delayed manifestations of opioid-induced rigidity. The mechanism of this complication is not well understood. In this report we describe a case of incidental overdose injection of sufentanil and subsequently review the confusing clinical features that require immediate diffenrentiation and the possible mechanim of this complication.
Analgesics, Opioid ; Muscle Rigidity ; Muscles ; Naloxone ; Sufentanil

Naltrexone in combining with the counselling, the familial intervention, the behaviorial management… was used at the Institute of Mental Health. After 1 month, the default had got 8.16%, after 3 months 14.28%. In all cases of normal SGOT, SGPT level before the treatment had got no change in the course of treatment, but in cases of increased enzyme levels before the treatment, they were abnormally changed. Urine test was (+) with narcotic drugs after 1 month 44%, 2 months 32.14%, 3 months 34.14%, 4 months 43.75%, 5 months 28%, 6 months 22.5%. A majority of addictive subjects did not believe on the clearing of heroine effect by naltrexone and some had got no correct motivation for the treatment. Criminal beheavior contrainted in the family was eliminated entirely after 1 to 2 months treatment. High risk beheavior among intravenous drug users, unsafe sexual activities were ceased after 1 month treatment. No HIV(+) patient was detected after 6 months treatment.
Analgesics, Opioid ; Therapeutics ; Morphine Dependence ; Naltrexone

Cancer pain is the most common and troublesome symptom for cancer patients. The more the cancer patient gets to the end of the life, the worse the pain. There are many clinical practice guidelines for cancer pain, and most pain can be controlled with appropriate medication by guideline. We would like to summarize various domestic and foreign clinical practice guidelines relatively simply. According to the clinical practice guidelines, medical treatment including opioids will greatly improve the quality of life of cancer patients.
Analgesics, Opioid ; Drug Therapy* ; Humans ; Quality of Life*