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Pain control in the ambulatory elderly.

R E Enck1

  • 1Ohio State University, Columbus.

Geriatrics
|March 1, 1991
PubMed
Summary

Managing pain in older adults presents unique challenges due to physiological changes affecting pain perception and medication sensitivity. Effective pain management involves careful assessment and a multimodal approach, including nonopioids and opioids.

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Area of Science:

  • Geriatrics
  • Pain Management
  • Pharmacology

Background:

  • Aging alters pain perception and increases sensitivity to analgesics.
  • Effective pain control in the elderly is a significant clinical challenge across various settings.
  • Unique physiological changes in older adults necessitate tailored pain management strategies.

Purpose of the Study:

  • To review principles for evaluating pain in elderly patients.
  • To discuss effective pharmacological and non-pharmacological approaches to pain management in geriatrics.
  • To address concerns regarding opioid use and addiction in the elderly population.

Main Methods:

  • Review of existing literature on pain management in the elderly.
  • Discussion of physiological changes associated with aging and their impact on pain.
  • Examination of assessment tools for objective pain evaluation.
  • Analysis of different classes of analgesics (nonopioids, opioids, adjuvants).

Main Results:

  • Older adults exhibit altered pain perception and enhanced sensitivity to opioid analgesics.
  • Objective pain assessment instruments are valuable for both physician and patient perspectives.
  • Nonopioid analgesics (acetaminophen, NSAIDs), opioid analgesics, and adjuvant agents can achieve good pain control.
  • Concerns about patient addiction and the World Health Organization (WHO) Cancer Pain Relief program are relevant.

Conclusions:

  • Pain management in the elderly requires a comprehensive approach considering age-related physiological changes.
  • A combination of nonopioids, opioids, and adjuvant therapies, alongside objective assessment, is key to effective pain control.
  • Addressing concerns about addiction and utilizing established programs like the WHO Cancer Pain Relief initiative are crucial for optimizing geriatric pain care.

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