Masui. The Japanese journal of anesthesiology
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Treatment of intractable chronic pain employs, nerve block, peripheral nerve stimulation, phototherapy, and drug therapy such as opioid and analgesia adjuvant. We also employ multi disciplinary approach with internal medicine, psychiatry and other related fields. In addition, in a portion of intractable chronic back pain, the pain relief is obtained by interventional approaches such as adhesionlysis and the neuroplasty with epiduroscopy as well as spinal cord stimulation therapy.
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Review
[Indication and usage of opioids except morphine for chronic non-malignant intractable pain].
Indication and usage of opioids except morphine for chronic non-malignant intractable pain were reviewed. In Japan, other than morphine, we can use only two opioids, codeine phosphate (codeine), and dihydrocodeine phosphate (dihydrocodeine) for non-malignant pain management according to medical insurance system. But in western countries sustained-release opioids such as MS contine, transdermal fentanyl, oxycontin were used for the management of non-malignant chronic pain. ⋯ Dihydrocodeine has twice analgesic efficacy compared to codeine. The initial dose is the same as codeine. We hope that sustained release opioids such as transdermal fentanyl, oxycontin, tramadol etc will be used in Japan for management of non-malignant chronic pain in the near future.