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世界卫生组织于1986年提出的“三阶梯止痛原则”是最基本的癌痛镇痛原则。根据此原则,轻度疼痛可选用非阿片类镇痛药,如非甾体类抗炎药(NSAIDs)和对乙酰氨基酚(扑热息痛);中度疼痛可选用可待因等弱阿片类药物,辅以NSAIDs或对乙酰氨基酚;重度疼痛则可选用吗啡等强阿片类药物,辅以NSAIDs或对乙酰氨基酚,以及辅助性镇痛药。在每一阶梯中,如果疼痛不能得到控制,应选择下一阶梯的药物,而不是再改用同一阶梯中其他药,以免疼痛得不到控制。选药时应尽可能选择给药途径简单、效果好、副作用少的药物。
World Health Organization in 1986 proposed “three-step painkiller principle ” is the most basic principles of pain relief. According to this principle, non-opioid analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (paracetamol) may be used for mild pain; weak opioids such as codeine may be used for moderate pain; Supplemented with NSAIDs or paracetamol; severe pain can choose morphine and other strong opioid supplemented with NSAIDs or paracetamol, and auxiliary analgesics. In each step, if the pain can not be controlled, the next step should be chosen instead of the other drugs in the same step so pain can not be controlled. Selection of drugs should be as simple as possible to choose routes of administration, the effect is good, less side effects of drugs.