28th May 2025

A 60-year-old woman with a history of ischaemic heart disease and ovarian cancer presents to palliative care clinic.

A 60-year-old woman with a history of ischaemic heart disease and ovarian cancer presents to palliative care clinic. She has been reviewed by your colleague monthly. She reports a burning pain in the front of her leg, which is worse at night. She was commenced on opioids a year ago and has slowly had these increased. She now takes 50mg oxycodone MR BD, with breakthrough 15mg IR oxycodone as required around three times a day. Her pain has not improved with the last three dose titrations.

How would you manage this patient’s pain?

Select the SINGLE most appropriate option from the list below. Select ONE option only.