The concept behind devising an analgesic ladder was to ensure proper diagnosis of pain with emphasis on its severity, and optimum pain relief using various classes of analgesics available.
The ladder goes two ways:
1. In case of chronic pain, usually the management starts from step 1 drugs i.e., non-opioid analgesics. If the pain is not responsive to non-opioid analgesics and NSAIDs, stepping up is required.
2. In case of acute pain e.g., in the management of post-operative pain, nerve blocks, epidural, and opioid analgesics are recommended.
Even though the management of pain should be done by specialists, WHO analgesic ladder makes it easy for practicing physicians to prescribe painkillers.
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