JUI-KUO HUNG MD,MHA

2012-09-15

Changhua Christian Hospital

Department of Orthopaedic Surgery

TAIWAN

Clinical Experiences of High-Dose Ultracet

High-Dose Ultracet

• Post-operative pain control

• Complicated spinal problems– Failed back syndrome

– Osteoporotic compression fractures

– Spinal cord injury

– Structural imbalance condition

• Autoimmune diseases

Post-Operative Pain Control

• Major surgery without PCA– Joint replacement – Spine surgery– Fracture

• Regimens– Celebrex 1# q12h or HS or

Acroxia 1# HS – Ultracet 1# Qid – Primparen, Gascon, Mgo

Through, Dramamine

Post-Operative Pain Control

• 2012/6~2012/8• 20 patients

– Spine 7– Arthroplasty 5– Fracture 8

• Adverse effect– Nausea 8– Dizziness 11– Abdominal fullness 9– Skin rashes 3

Failed Back Syndrome

• NSAID, muscle relaxants, steroid,

Neurodantin, anti-anxiety agent…..• Ultracet

– 1#~2# Qid – VAS around 3~4

Spinal Cord Injury

Spinal Cord Injury

• Ultracet 1#~2# Qid• VAS around 3~4

Osteoporotic Compression FracturesStructural Imbalance Condition

• Most patients– 1# Bid at first– ↑ to 1#~2# Qid– Titrate to 1# Bid

• Severe patients with chronic pain– 1#~2# Qid– Other medications

Autoimmune Diseases

• NSAID• DMARDs

– Methotrexate– Hydrochloroquine– Sulfalazine

• Anticytokine therapy• B cell direct therapy …• Ultracet

– Acute 1#~2# Qid– Chronic 1# Qid~Bid

High-Dose Ultracet

• Post-operative pain control

• Complicated spinal problems– Failed back syndrome

– Osteoporotic compression fractures

– Spinal cord injury

– Structural imbalance condition

• Autoimmune diseases

Thank You