Which approach is used in Step 2 of the WHO pain management ladder?

Step 2 of the WHO pain management ladder focuses on the comprehensive approach to managing moderate pain. The correct option, which involves maintaining the use of non-opioid analgesics (like NSAIDs or acetaminophen) from Step 1 while adding a low-dose opioid, is essential for effectively relieving moderate pain. This strategy enhances analgesia without completely replacing the non-opioid medications that may be providing some relief.

The inclusion of a low opioid allows for better control of pain for patients whose needs are not adequately met by non-opioid medications alone. This dual approach can maximize pain relief and minimize side effects often associated with higher doses of opioids.

In contrast, using only NSAIDs would not provide adequate relief for moderate pain. Transitioning directly to stronger opioids in this step alone overlooks the potential benefits of combination therapy and could escalate the risk of opioid-related adverse effects. Similarly, relying solely on adjuvants neglects the importance of addressing pain through both non-opioid and opioid analgesics, which is integral to effective pain management as outlined by the WHO. Thus, the option of maintaining Step 1 and adding a low opioid represents the balanced, stepwise approach that the WHO advocates for managing pain effectively.