He was managed using a multimodal analgesia approach. A 2mg PCA bolus dose of oxycodone was combined with paracetamol, clonidine and pregabalin.
He had nicotine patches during his hospital admission and was offered support to continue with smoking cessation on discharge.
He was offered referral for consideration of a coeliac plexus block but declined as he had previously been told that it had a low chance of helping long term and disliked the idea of an invasive procedure.
He acknowledged that the stress of moving areas may have contributed to his current flare, but did not want to engage with any stress management techniques. Referral to the out-patient pain clinic was also suggested but he felt he had already explored this route at his previous hospital.
His pain reduced to a manageable level after 5 days and he was discharged with his previous dose of modified-relief oxycodone and pregabalin. Gradually reducing his opioid dose was advised but he was unkeen on this plan due to fear of increasing his pain.
