Following surgery, a patient on maximum analgesia continues to have pain. Which action would be most suitable to manage her pain?

• A. Prescribe a regular sustained release preparation of morphine
• B. Discontinue morphine altogether
• C. Increase ibuprofen dose beyond maximum
• D. Offer non-pharmacological therapy only

Answer: (A)

When postoperative pain remains despite high-dose analgesia, the goal is to provide steady, baseline pain control rather than rely solely on intermittent doses. A sustained-release morphine given on a regular schedule maintains consistent opioid levels in the body, reducing pain fluctuations and preventing breakthrough pain. This approach addresses the ongoing pain more effectively than PRN dosing, by ensuring a constant analgesic effect that supports healing and comfort.

Discontinuing morphine would leave the patient in pain. Increasing the NSAID dose beyond safe limits risks serious side effects and may still be inadequate for severe postoperative pain. Relying on non-pharmacological therapies alone won’t provide the necessary analgesia in the immediate postoperative period.