Opioids and their proper use as analgesics in the management of head and neck cancer patients.
Opioid analgesics play an important part in the interdisciplinary management of head and neck cancer patients. Acute pain during the initial treatment period and chronic pain after treatment may be undertreated by head and neck surgeons because of unwarranted fear of the opioid side effects and toxicities. Properly used, opioid analgesics are among the safest and most effective medications in the armamentarium of the head and neck surgeon. Knowledge of opioid pharmacology can help surgeons treat pain aggressively in patients while managing side effects and toxicities. This understanding can also address the unique problems in pain management presented in head and neck cancer patients attributable to the involvement by the disease of the aerodigestive tract, which interferes with the oral route of administration of opioid analgesics. Significant difficulties in the use of opioid analgesics arise when the patient is a substance abuser. This article discusses the basic principles of opioid pharmacology, discusses opioid use in head and neck cancer patients, and provides guidelines on the use of opioids in the substance abuser.
Department of Otolaryngology--Head & Neck Surgery, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
A R
AR
Thompson
D000208:Acute Disease; D000698:Analgesia / Q000379:methods*; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011379:Prognosis; D018570:Risk Assessment
D009294:Narcotics