Paediatric Palliative Care Guidelines
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Pain - Introduction
Pain Classification
Pain Diagnosis
Pain - Drug management
WHO Pain Guidelines
Initiating morphine
Morphine titration
Managing morphine maintenance
Adverse effects of morphine
Opioid rotation
Alternatives to morphine
Equianalgesic potencies
Golden rules of pain control
Adjuvant pain therapies
Pain Classification
Pain Diagnosis
Pain - Drug management
WHO Pain Guidelines
Initiating morphine
Morphine titration
Managing morphine maintenance
Adverse effects of morphine
Opioid rotation
Alternatives to morphine
Equianalgesic potencies
Golden rules of pain control
Adjuvant pain therapies
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Edition/Revision: 1.0
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Managing the maintenance phase on morphine - Archived
- Titration ends and the maintence phase begins when it is no longer necessary to keep adjusting the total daily dose of regular opioid. At this point it is usually helpful to change to a long acting formulation.
- 1st line: slow release morphine preparations that can be given 12hrly (e.g. MST)
- 2nd line: Fentanyl or Buprenorphine patches
- It is not necessary for the breakthrough opioid to be the same as the regular one (e.g. a child with a Fentanyl patch could take an appropriate dose of Oramorph for breakthrough).
- Continue to review on a regular basis.
- Sometimes the dose may need to be revised downwards rather than increased.
Edition/Revision: 1.0
Created 18 Jul 2013 - Archived
Validated 19 Jul 2013 by Ian Back
Last modified 8 Dec 2023
Validated 19 Jul 2013 by Ian Back
Last modified 8 Dec 2023
