53 / 604
Opioid tolerance in advanced cancer patients?
“Progressive need for uptitration of opioid dose
to maintain the same analgesic effect”
After stabilisation (14d) on oral morphine
è
VAS-score <3,5
Change of morphine
è
equivalent dose TTS-fentanyl,
oral morphine is free available for break through pain (BTP)
Dose fentanyl is up-titrated if oral morphine ≥ 60mg/d for BT
Opioid tolerance:
1- Is so important that opioids are best reserved for patients in
their last year of life (to prevent analgesic ineffectiveness)
2- Does exist but can not justify witholding opioids
3- Does not exist in cancer patients
4- I don’t know