Mr Harry is a 59-year-old man who was admitted 4 days ago following a motorcycle accident. He sustained
a fractured R humerus. He underwent internal fixation of the fracture 3 days ago, and recovery has been
uneventful. Past medical history: major gastrointestinal haemorrhage from a gastric ulcer 2 years ago,
fractured femur 5 years ago, Ischaemic Heart Disease,
Previous analgesic use is limited to an occasional paracetamol for headaches. He is married and has two
adult children.
He describes his pain as aching in the shoulder region, which there most of the time. He scores his pain at
2/10. It fluctuates between 1/10 and 3/10 throughout the day.
What analgesic and management plan including dose and frequency would you chose for this person?
Assume he has had no medication today. Explain your rationale.
Sample Solution