Dolor y analgésicos

Abstract

Pain is as old as the human beings. Classical civilizations attributed the painful sensation to natural or divine punishments, and in fact, the first “treatments” applied to calm it did have an important magical component. The beginning of modern pharmacology in the mid-nineteenth century together with the development of a powerful pharmaceutical industry propelled the commercialization and widespread use of the first active ingredients with analgesic activity. Since then, the consumption of painkillers occupies a very important part of global health spending. Its use has become popular due to the wide assortment of drugs available, for some of which no prescription is required. Parallel to this massive consumption, the number of associated adverse reactions has also multiplied. For this reason, it is becoming increasingly necessary to know well the therapeutic arsenal that we have, as well as educating patients in analgesic medicines optimisation. For the approach to chronic pain, the WHO proposes an analgesic scale, originally intended for chronic pain associated with tumours, but which has subsequently been extended to pain of diverse etiology. As a first step, the use of non-steroidal anti-inflammatory drugs is proposed, to which coadjuvants can be added, to end up treating the pain with opioids. A well-planned strategy will allow pain control with a dosage that minimizes its adverse effects.