How To Manage Surgical Pain In Elderly Patients
- Volume 18 - Issue 7 - July 2005
- 10506 reads
- 0 comments
The elderly are more vulnerable to inadequate pain control so it is important to encourage them to take a more proactive role in their health care. The goal of safe and effective pain management ideally begins by counseling and advising the older patient prior to surgery on what to expect. Understanding the characteristics of the aforementioned common analgesics should hopefully provide insight for the podiatric surgeon in selecting an appropriate analgesic for this age group.
Dr. Juda is an Assistant Professor in the Department of Medicine at the Temple University School of Podiatric Medicine. He is in private practice in Christiana, Del.
1. Hargreaves KM, Dionee RA. Evaluating endogenous mediators of pain and analgesia in clinical studies. Portenoy R, Laska E (Editors). Advances In Pain Research and Therapy: The Design of Analgesic Clinical Trials. Raven Press, New York. 579-598, 1991.
2. Gloth FM. Principles of perioperative pain management in older adults. Clinics in Geriatric Medicine 17(3) 553-573, August 2001.
3. World Health Organization: Cancer Pain Relief. World Organization Technical Report Series 804. World Health Organization, Geneva, 1996.
4. The management of chronic pain in older persons: American Geriatrics Society (AGS) panel on chronic pain in older persons. Journal of American Geriatric Society 46:635-651, 1998.
5. McCaffrey M, Pasero C. Pain: Clinical Manual. Mosby, St. Louis, Mo. 1999.
6. Chutka DS, Takahashi PY and Hoel RW. Inappropriate medication in elderly patients. Mayo Clinic Proc. 79:122-139, 2004.
7. French EH. ADRs and metabolic changes in the elderly. U.S. Pharmacist, H6-H16, May 1994.
8. Syntex Laboratories: Toradol package insert. Palo Alto, Ca. 1996.
9. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Of Internal Medicine 151:1825-1832, 1991.
10. Savage SR. Opioid use in the management of chronic pain. Medical Clinics of North America. 83(3):761-765, May 1999.
11. Education for Physicians In End-Of-Life Care: Pain Management. Emmanuel LL, Von Gunten CF, Ferris FD (eds.). The Education for Physicians on End-Of-Life Care (EPEC) Curriculum: EPEC Project. The Robert Wood Johnson Foundation. New Brunswick, NJ 1-35, 1999.
12. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. Archives of Internal Medicine 157:1531-1536, 1997.
13. Christian JB, Van Haaren A, Cameron KA, Lapane KL. Alternatives for potentially inappropriate medications in the elderly population: treatment algorithms for use in the Fleetwood Phase III study. The Consultant Pharmacist 19(11):1011-1028, November 2004.
14. Kamal-Bahl, SJ, Doshi JA, Stuart BC, et. al. Propoxyphene use by community-dwelling and institutionalized elderly Medicare beneficiaries. Journal of American Geriatric Society 51:1099-1104, 2003.
15. Ferrell BA. Pain management. Hazzard WR, Blass JP, Ettinger WH, Halter JB, Ouslander JG (eds.). Principles of Geriatric Medicine and Gerontology. 413-499. McGraw-Hill, New York, 1999.
16. Egbert AM. Postoperative pain management in the frail elderly. Clinical Geriatric Medicine 12(3), 1996.