[Analgesia in patients with hepatic impairment].
The lack of clear recommendations makes optimal pain management difficult in patients with hepatic function impairment. This article reviews the evidence on commonly used analgesics (paracetamol, NSAIDs, opiates). Paracetamol can be safely used at low doses (2-3 grams per day) for a period not exceeding a few days. NSAIDs should be avoided because of their direct hepatic toxicity and an increased risk of life-threatening side-effects (hemorrhagic, renal). Glucuronoconjugated opiates should be preferred but all must be used carefully because of the risk of side effects. Dosage reduction and/or increased dose interval are often required.
Giovanni
G
Innaurato
Valérie
V
Piguet
Martine Louis
ML
Simonet
D000082:Acetaminophen / Q000627:therapeutic use; D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000378:metabolism; D010146:Pain / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D059408:Pain Management / Q000009:adverse effects / Q000379:methods
D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen