Recommendations for the use of opioids in Brazil: Part III. Use in special situations (postoperative pain, musculoskeletal pain, neuropathic pain, gestation and lactation)

BACKGROUND AND OBJECTIVES: The use of opioids as first and second line agents to adequately treat pain requires systematization in different clinical syndromes which course with acute pain. This study aimed at discussing recommendations for the use of opioids in acute postoperative pain, neuropathic pain, musculoskeletal pain and pain during gestation and lactation.CONTENTS: This review has addressed the use of opioids in frequent chronic and acute painful syndromes, in gestation and lactation, discussing indications, drugs used, doses, risks, complications and recommendations.CONCLUSION: Opioids for acute postoperative pain have been broadly studied and are established for minor medium and major surgeries. Recommendations for the use of opioids in neuropathic and musculoskeletal pain are restricted to second line treatment and require further discussions. Few studies have investigated the interaction of opioids with physiologic changes typical of gestation and the repercussions of the use of such agents to treat acute and chronic pain in the short and long term.