Pain management in patients with cirrhosis

Clinical Liver Disease

Issues in Cirrhosis

Volume 11, Issue 6

Pages: 135-161

Clinical Liver Disease (CLD) is an online learning resource of American Association for the Study of Liver Diseases. CLD blends text, audio, video, webinars, and other interactive content into educational interventions launched every other month.

The latest publication of Clinical Liver Disease is all about cirrhosis, with a summary featuring: Pain management in patients with cirrhosis. 

Many of the commonly used over-the-counter analgesics such as acetaminophen and prescription pain relievers are metabolized through the liver, posing unique pain management challenges for patients and clinicians. This review will highlight the latter, and discuss the use of opioids, antidepressants, and marijuana, as well.

Patients with cirrhosis often experience pain. Yet pain remains one of the most undertreated symptoms in this patient population. A variety of medications are available to help address pain; however, several factors have to be taken into consideration prior to starting any pain regimen in patients with cirrhosis. Factors to consider include potential for overuse/abuse, severity of hepatic and renal impairment, and presence of hepatic encephalopathy. Chronic pain can be well managed in patients with cirrhosis; however, choice of analgesic and dosing regimen should be highly individualized and side effects carefully monitored.

Pain management in patients with cirrhosis (pages 135–140)

Mina Rakoski, Preeya Goyal, Michelle Spencer-Safier, Jill Weissman, Gina Mohr and Michael Volk
Version of Record online: 26 JUL 2018 | DOI: 10.1002/cld.711

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Abstract
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Table of Contents

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