Table 4 Severe Pain (NRS 8–10 out of 10) – Expert derived recommendations for Round 2 and 3
From: Acute postoperative pain management protocols in podiatric surgery within Australia: a Delphi study
Delphi Statement | Consensusa,b (Median) | Interquartile rangec | ||
|---|---|---|---|---|
Round 2 | Round 3 | Round 2 | Round 3 | |
The following should be prescribed for mild postoperative pain after osseous and/or soft tissue type podiatric surgery: | ||||
 Oral paracetamol. | A (6) | A (7) | 3.5–9 | 3.25–9 |
 Oral paracetamol SR 665 mg. | A (5) | N (6) | 3.5–8.75 | 4.25–8.25 |
 An oral COX-2 inhibitor. | A (9) | A (9) | 7.5–9 | 7.25–9 |
 An oral non-selective NSAID. | A, N (5.5) | A, N (6) | 4.25–8.5 | 4.25–7 |
 An oral opioid combination product. | A (8.5) | A, N (6.5) | 7–9 | 5.25–7.75 |
 Oral oxycodone. | A (8.5) | A (8) | 8–9 | 7–8.75 |
 Oral tramadol. | A (7.5) | A (7.5) | 7–8 | 6.25–8.75 |
 Oral tapentadol IR. | A (8.5) | A (8) | 7.25–9 | 7.25–8.75 |
 Oral tapentadol SR. | A (7.5) | A (7) | 7–8 | 6.25–8 |
 Sublingual buprenorphine. | A (8) | A (7) | 5–8 | 3.25–7.75 |
 Postoperative oral opioids should be prescribed for a shorter duration for soft tissue procedures than osseous procedures. | A (7.5) | A (7) | 5.25–8.75 | 5–7.75 |
 Oral opioids such as paracetamol plus codeine, oxycodone, tapentadol, or tramadol should be prescribed for breakthrough pain. | A (9) | A (9) | 8.25–9 | 9–9 |