What are the most common painkillers in hospitals?

October 9, 2025 •

3 min read

According to the National Institutes of Health, effective pain management is a crucial component of patient care, with a multimodal approach often used in hospital settings. This strategy combines various classes of medications to maximize pain relief while minimizing risks associated with any single drug class, especially when considering what are the most common painkillers in hospitals. The types and administration of these medications are tailored to each patient’s specific needs and the severity of their pain.

Quick Summary

This article explores the most common pain medications used in hospital settings. It covers opioids like morphine and fentanyl, non-opioids such as NSAIDs and acetaminophen, and local anesthetics. It details different administration methods like IV and PCA and explains the multimodal approach to effective pain control.

Key Points

Multimodal Approach: Hospitals use a combination of different painkiller classes and administration methods to improve pain control and reduce side effects.
Opioids for Severe Pain: Potent opioids like morphine, fentanyl, and hydromorphone are reserved for managing moderate to severe acute pain.
Non-opioids for Milder Pain: Medications like acetaminophen and NSAIDs are used for mild-to-moderate pain or as adjuncts to reduce opioid requirements.
Diverse Administration Routes: Hospitals utilize routes such as oral, intravenous (IV), patient-controlled analgesia (PCA), and epidural injections to suit different pain needs.
Specialized Pain Relief: Local anesthetics are used for targeted relief via nerve blocks, while adjuvant drugs like gabapentinoids and ketamine address specific pain types, like neuropathic pain.
Safety and Monitoring: The use of powerful hospital painkillers requires careful monitoring for potential side effects, including respiratory depression with opioids.

Multimodal Pain Management in Hospitals

Modern hospital pain management follows a multimodal approach, which involves using a combination of different analgesic agents and techniques to target various pain pathways. This strategy often allows for lower doses of each drug, reducing the potential for side effects while achieving superior pain control. A patient's pain treatment plan is highly individualized and considers their specific condition, the nature and intensity of their pain, and potential risks.

Opioids

For moderate to severe pain, opioids remain a cornerstone of hospital treatment due to their potent analgesic effects. They work by binding to opioid receptors in the central nervous system, effectively blocking pain signals.

Morphine

As a standard for potent pain relief, morphine is widely used, particularly intravenously (IV) for rapid onset and patient-controlled analgesia (PCA).

Fentanyl

Fentanyl is a highly potent, synthetic opioid with a rapid onset and short duration, making it a preferred choice for acute pain management and for use in anesthesia. It is commonly administered intravenously or via transdermal patches for continuous relief in certain settings.

Hydromorphone (Dilaudid)

Hydromorphone is another potent opioid, often used intravenously or orally, offering a strong analgesic effect for severe pain.

Oxycodone

Often combined with acetaminophen (Percocet), oxycodone is used for managing moderate to severe pain, typically in pill form for patients who can tolerate oral medication.

Non-Opioid Analgesics

Non-opioid medications are a crucial part of the multimodal strategy, used for mild to moderate pain or in combination with opioids to reduce their dosage.

Acetaminophen

Acetaminophen (Tylenol), or paracetamol, is a first-line treatment for mild to moderate pain and can be administered orally or intravenously. It is well-tolerated and lacks the gastrointestinal and cardiovascular side effects associated with NSAIDs.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, which reduce pain and inflammation by inhibiting cyclooxygenase (COX) enzymes, are commonly used for inflammatory and mild to moderate pain.

Ibuprofen: Often used for musculoskeletal pain, it can be given orally or intravenously.
Ketorolac (Toradol): This injectable NSAID is used for moderate to severe pain, especially post-operatively, to reduce the need for opioids.

Local Anesthetics

Local anesthetics block nerve signals in a targeted area, providing localized pain relief.

Lidocaine and Bupivacaine

These are frequently used in peripheral nerve blocks and epidural analgesia to numb a specific part of the body, which is highly effective for post-surgical pain.

Adjuvant Analgesics

Adjuvant medications are used to treat certain types of pain that do not respond well to standard painkillers or to enhance the effects of other drugs.

Gabapentinoids

Drugs like gabapentin (Neurontin) and pregabalin (Lyrica) are anticonvulsants that can be effective in treating neuropathic pain.

Ketamine

In low, sub-anesthetic doses, ketamine is increasingly used intravenously as an adjunct for patients with severe pain, especially those with opioid tolerance.

Routes of Administration

In a hospital, medication can be delivered through several routes, chosen based on the patient's condition and the desired speed and duration of effect.

Intravenous (IV): Provides the most rapid onset of pain relief and is ideal for severe, acute pain. IV delivery is also used for PCA.
Oral (PO): The most convenient and cost-effective route, used for patients who can swallow.
Patient-Controlled Analgesia (PCA): A system allowing patients to self-administer a controlled dose of IV opioid, giving them more autonomy over their pain management.
Epidural: Involves injecting medication directly into the epidural space of the spine, providing powerful regional analgesia.

Conclusion

Understanding what are the most common painkillers in hospitals and the multimodal approach to pain management provides a clearer picture of modern hospital care. By combining various classes of analgesics and leveraging different routes of administration, medical teams can provide tailored, effective pain relief while minimizing side effects and encouraging a smoother recovery. The evolution of pain management away from a sole reliance on potent opioids towards a more balanced regimen underscores a commitment to patient safety and comprehensive care.


Painkiller Class	Common Hospital Examples	Administration Routes	Primary Use	Potential Side Effects
Opioids	Morphine, Fentanyl, Hydromorphone	IV, PCA, Oral, Epidural	Severe Acute & Post-Operative Pain	Sedation, Constipation, Respiratory Depression
NSAIDs	Ibuprofen, Ketorolac	Oral, IV, IM	Mild to Moderate Pain, Inflammation	GI Irritation, Renal Dysfunction, Bleeding
Acetaminophen	Tylenol (IV and Oral)	Oral, IV, Rectal	Mild to Moderate Pain, Adjunct Analgesic	Liver Toxicity (at high doses)
Local Anesthetics	Lidocaine, Bupivacaine	Nerve Block, Epidural, Topical	Localized Pain, Post-Surgical Analgesia	Numbness, Hypotension (with epidural)
Adjuvant Analgesics	Gabapentin, Pregabalin, Ketamine	Oral, IV	Neuropathic Pain, Severe Pain (Ketamine)	Dizziness, Sedation, Cognitive Effects

Frequently Asked Questions

In a hospital, painkillers are often stronger and can be administered intravenously (IV) or through specialized devices like a PCA pump for severe pain. While some drugs like Ibuprofen and Acetaminophen are the same, the hospital environment allows for higher potency and faster delivery methods under close medical supervision.

PCA is a method of pain relief where a patient controls the administration of a set dose of pain medication, typically an opioid, by pressing a button. This gives the patient autonomy while built-in safety features prevent accidental overdose.

No, a multimodal approach is preferred. While opioids are used for severe pain, non-opioid medications like acetaminophen and NSAIDs are often used first or in combination to manage pain and reduce the need for potent opioids.

Multimodal pain management is a strategy that combines different classes of pain medication and non-drug therapies to target multiple pain pathways simultaneously. This maximizes pain relief while minimizing side effects associated with high doses of a single medication.

Local anesthetics like lidocaine and bupivacaine are used to numb specific parts of the body. In a hospital setting, this can involve injecting them for a peripheral nerve block, wound infiltration, or for an epidural to provide regional pain relief.

Opioids can cause constipation, nausea, and in rare cases, respiratory depression. NSAIDs can lead to gastrointestinal irritation or bleeding. A medical team monitors patients closely for these and other potential side effects.

In some cases, adjuvant medications that are not primarily painkillers are used to help manage pain. Examples include gabapentinoids for neuropathic pain or low-dose ketamine for severe pain, as they work on different pain pathways.