• Revue médicale suisse · Jun 2015

    Review

    [Analgesia in patients with hepatic impairment].

    • Giovanni Innaurato, Valérie Piguet, and Martine Louis Simonet.
    • Rev Med Suisse. 2015 Jun 24;11(480):1380, 1382-4.

    AbstractThe 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.

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