Pain management in older adults: Prevention and treatment

被引:108
作者
Gloth, FM
机构
[1] Univ Maryland, Johns Hopkins Univ, Sch Med, Union Mem Hosp, Baltimore, MD USA
[2] Hospice Network Maryland, Baltimore, MD USA
关键词
pain management; older people; opioids; hospice; cancer pain; arthritis; palliative care; end-of-life care; pain assessment; analgesics;
D O I
10.1046/j.1532-5415.2001.49041.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
The release of guidelines in 1998 by the American Geriatrics Society on "The Management of Chronic Pain in Older Persons" was a breakthrough in helping to manage pain in this population. Already advances have fostered a need to update recommendations. This article focuses on the treatment strategies available for seniors that are likely to help to fulfill the obligation to relieve pain and suffering in patients. A review was done of the literature using Medline and other search techniques. New pain scales have been developed with seniors in mind and greater testing of older scales in elderly populations have helped to identify measures of pain more suited to frail seniors. Advances in cyclooxygenase inhibition selectivity, alternative medicine, and progress in the identification of nonopioid pain receptors and the development of products to target them are just a few of changes chat have altered the way clinicians think about treating pain. The use of hospice in end-of-life palliative care is a valuable resource for clinicians managing pain at that phase in care as well. Tools are available to prevent and treat pain successfully in seniors. Educating clinicians about available assessment tools, techniques and interventions may be the biggest challenge to comforting the older adult in pain.
引用
收藏
页码:188 / 199
页数:12
相关论文
共 95 条
  • [1] ALLEN KL, 1976, CANCER, V37, P984, DOI 10.1002/1097-0142(197602)37:2<984::AID-CNCR2820370255>3.0.CO
  • [2] 2-C
  • [3] ANDERSEN S, 1987, PAIN S, V4, P332
  • [4] ARNST C, 1999, BUS WEEK, V3, P103
  • [5] Broad-spectrum, non-opioid analgesic activity by selective modulation of neuronal nicotinic acetylcholine receptors
    Bannon, AW
    Decker, MW
    Holladay, MW
    Curzon, P
    Donnelly-Roberts, D
    Puttfarcken, PS
    Bitner, RS
    Diaz, A
    Dickenson, AH
    Porsolt, RD
    Williams, M
    Arneric, SP
    [J]. SCIENCE, 1998, 279 (5347) : 77 - 81
  • [6] Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma
    Berenson, JR
    Lichtenstein, A
    Porter, L
    Dimopoulos, MA
    Bordoni, R
    George, S
    Lipton, A
    Keller, A
    Ballester, O
    Kovacs, MJ
    Blacklock, HA
    Bell, R
    Simeone, J
    Reitsma, DJ
    Heffernan, M
    Seaman, J
    Knight, RD
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1996, 334 (08) : 488 - 493
  • [7] BLIWISE DL, 1994, J AM GERIATR SOC, V42, P1009
  • [8] COMPARISON OF AN ANTIINFLAMMATORY DOSE OF IBUPROFEN, AN ANALGESIC DOSE OF IBUPROFEN, AND ACETAMINOPHEN IN THE TREATMENT OF PATIENTS WITH OSTEOARTHRITIS OF THE KNEE
    BRADLEY, JD
    BRANDT, KD
    KATZ, BP
    KALASINSKI, LA
    RYAN, SI
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (02) : 87 - 91
  • [9] BROOKS PM, 1991, NEW ENGL J MED, V324, P1716
  • [10] COMPARISON OF AMITRIPTYLINE, CYCLOBENZAPRINE, AND PLACEBO IN THE TREATMENT OF FIBROMYALGIA - A RANDOMIZED, DOUBLE-BLIND CLINICAL-TRIAL
    CARETTE, S
    BELL, MJ
    REYNOLDS, WJ
    HARAOUI, B
    MCCAIN, GA
    BYKERK, VP
    EDWORTHY, SM
    BARON, M
    KOEHLER, BE
    FAM, AG
    BELLAMY, N
    GUIMONT, C
    [J]. ARTHRITIS AND RHEUMATISM, 1994, 37 (01): : 32 - 40