RUBIO, A.; MUNOZ, E.    SIERRA, R.. To annul or to shorten the first steps of the WHO Analgesic Leader. []. , 15, 1, pp.13-20. ISSN 1134-8046.

Objective: This study was designed to evalúate the possibility of either shorten or annul the first and second level of the WHO-analgesic ladder; in order to achieve pain control in patientes suffering from OA within the shortest period of time. Material and Methods: - First group pain was not adequately controlled by non-opioid analgesic and afterwards treated with TD-Fentanyl. - The second group was treated with TDF after not being adequately controlled by weak opoids, with a dose that ranged between 1 mg up to 3 mg/kg. - The third group was treated with TDF after a dose of weak opioids (tramadol) which ranged between 3,5 mg up to 6 mg/kg. Results: Results related to pain control, adverse effects and therapy discontinuing, were statistically and clinically similar among the three groups. Conclusion: It is possible to shorten the period of time necessary to achieve pain control in patients who suffer from chronic pain related to OA by shorting or avoiding the second or first level of the WHO-anlgesic ladder.

: Fentanyl; tramadol; WHO-analgesic ladder; WHO-analgesic ladder first level suppression as treating chronic pain.

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