Question

Your patient is 12-hours post ORIF right ankle. The patient is asking for pain medication. The pain-medication orders are written as a combination of a narcotic analgesic and a non-steroidal anti-inflammatory (NSAID) given together. What is the rationale for administering pain medication in this manner? *

Answer 1

The rationale for administering a combination of a narcotic analgesic and a non-steroidal anti-inflammatory (NSAID) given together for a patient who is status post ORIF right ankle is due to their action. Narcotic analgesics bind to opioid receptors that control pain located on neuronal cell membranes. These are abundantly seen in the brain and the spinal cord. NSAIDs induce pain control by inhibiting the action of cyclooxygenase enzymes, which are involved in the synthesis of inflammation-causing prostaglandins. The narcotic analgesics and NSAIDs are used together based on the nature of pain for which each category is effective. Narcotic analgesics are given for severe pain relief associated with surgery, while the NSAIDs are administered for muscular aches of inflammatory origin. Since two types of pain exist together 12-hours post ORIF these two types are administered in combination.