The development and efficacy of the WHO analgesic ladder

Augusto Caraceni and Stefan Grond

in Opioids in Cancer Pain

Published on behalf of Oxford University Press

ISBN: 9780199218806
Published online May 2011 | e-ISBN: 9780199607006 | DOI:

Series: Oxford Pain Management Library OPML P

The development and efficacy of the WHO analgesic ladder

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  • Clinical Oncology
  • Pain Medicine


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Use of the WHO analgesic ladder can control pain due to cancer for the majority of patients. The ladder is based on simple principles such as: simplicity in the choice of analgesic; simplicity in the choice of route; individualization of dose, particularly of strong opioids; continuous pain requires continuous medication; use of adjuvant analgesics; treatment of adverse effects to allow adequate dose titration. The principles of the WHO ladder should be applicable in all care settings. While there are no randomized controlled trials (RCTs) of the method, these would now be impossible as it is accepted as the gold standard worldwide.

Chapter.  1958 words.  Illustrated.

Subjects: Clinical Oncology ; Pain Medicine

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