ReviewJournal of pain research2018
Practical management of opioid rotation and equianalgesia.
Review in Journal of pain research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 121 citations in OpenAlex.
- Opioid conversion in adults with cancer: MASCC-ASCO-AAHPM-HPNA-NICSO guideline.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Guideline
- Sympathetic nerve blocks for persistent pain in adults with inoperable abdominopelvic cancer.The Cochrane database of systematic reviews · 2024Pooled it
- The effects of intravenous lidocaine on wound pain and gastrointestinal function recovery after laparoscopic colorectal surgery.International wound journal · 2020Pooled it
- Effects of Oxycodone versus Sufentanil-Based Intravenous Patient-Controlled Multimodal Analgesia on Early Gastrointestinal Recovery and Pain After Laparoscopic Colorectal Cancer Surgery: A Randomized Double-Blind Trial.Journal of pain research · 2026Trial
- Effect of Oxycodone-Based Multimodal Analgesia on Visceral Pain After Major Laparoscopic Gastrointestinal Surgery: A Randomised, Double-Blind, Controlled Trial.Drug design, development and therapy · 2024Trial
- Trial
- Continuous Adductor Canal Block used for postoperative pain relief after medial Unicondylar Knee Arthroplasty: a randomized, double-blind, placebo-controlled trial.BMC anesthesiology · 2019Trial
- Association Between Intraoperative Arterial Oxygen Tension and Postoperative Opioid Consumption: A Large-Scale Cohort Study Using Overlap Weighting Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Analysis of Factors Affecting Postoperative Opioid Requirement in Adult Patients Undergoing Minimally Invasive Repair of Pectus Excavatum.Journal of clinical medicine · 2026Article
- Association Between Preoperative Single Dose of Dexamethasone and Postoperative Outcomes in Elderly Patients with Gastric Cancer.Drug design, development and therapy · 2026Article
- Article
- Efficacy and Safety of Peripheral Nerve Blocks After Arthroscopic Shoulder Surgery: A Systematic Review and Network Meta-Analysis.Journal of pain research · 2026Review
- Contrast-enhanced CT-based prediction models for early intervention efficacy and in-hospital mortality risk in acute necrotizing pancreatitis with persistent organ failure.European radiology · 2025Article
- A systematic review and meta-analysis to identify vertical limits for a high-dose opioid therapy.Neurological research and practice · 2025Review
- Influencing factor analysis and clinical efficacy of early intervention in severe acute pancreatitis with persistent organ failure.Scientific reports · 2025Observational
- Benefits ofInternational journal of molecular sciences · 2025Article
- Distributed Opioids in Morphine Equivalent: A Global Measure of Availability for Palliative Care.Journal of pain and symptom management · 2025Article
- Patient-controlled analgesia with hydromorphone treatment for advanced colon cancer with severe pain in an older adult patient: a case report and literature review.Journal of gastrointestinal oncology · 2024Article
- Low-dose methadone added to another opioid for cancer pain: a multicentre prospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Exceeding the guideline-recommended maximum daily dose of opioids for long-term treatment of non-cancer pain in Germany - a large retrospective observational study.BMC public health · 2024Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo review the recent literature on opioid rotation (ie, switching from one opioid drug to another or changing an opioid's administration route) in cancer patients experiencing severe pain and to develop a novel equianalgesia table for use in routine clinical practice.
methodsThe MEDLINE database was searched with terms "cancer pain," "opioid rotation," "opioid switching," "opioid ratio," "opioid conversion ratio," and "opioid equianalgesia" for the major opioids (morphine, oxycodone, fentanyl, and hydromorphone) and the intravenous, subcutaneous, oral, and transdermal administration routes. Selected articles were assessed for the calculated or cited opioid dose ratio, bidirectionality, and use of the oral morphine equivalent daily dose or a direct drug-to-drug ratio.
resultsTwenty publications met our selection criteria and were analyzed in detail. We did not find any large-scale, prospective, double-blind randomized controlled trial with robust design, and most of the studies assessed relatively small numbers of patients. Bidirectionality was investigated in seven studies only.
conclusionThe updated equianalgesic table presented here incorporates the latest data and provides information on bidirectionality. Despite the daily use of equianalgesic tables, they are not based on high-level scientific evidence. More clinical research is needed on this topic.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.