Kongsgaard Ulf E, Wyller Torgeir Bruun, Breivik Harald
Anestesi- og intensivklinikken Rikshospitalet og Det medisinske fakultet Universitetet i Oslo.
Tidsskr Nor Laegeforen. 2008 Feb 28;128(5):590-1.
Age distribution in developed countries is currently shifting towards older age. However, knowledge regarding diseases and treatment of the oldest patients remains incomplete, especially when it comes to acute and chronic pain. Pain assessment is complicated in these patients as they often have more than one diagnosis contributing to the clinical picture, in addition age-related changes in pain perception and cognitive impairment render evaluation of subjective symptoms difficult. Multidisciplinary pain management programmes that combine pharmacologic and non-pharmacologic treatment have proven efficacious in elderly patients. The choice of analgesics demands an understanding of age-related changes in drug-metabolism, co-morbidity and concurrent medication. Adjustment of drug doses and evaluation of benefits and risks should be tailored to each individual. There is an urgent need for better professional education programmes and further dedicated research specifically targeted to the needs of the elderly in our community.
发达国家的年龄分布目前正朝着老龄化转变。然而,关于最年长患者的疾病和治疗的知识仍然不完整,尤其是在急性和慢性疼痛方面。这些患者的疼痛评估很复杂,因为他们往往有不止一种诊断影响临床表现,此外,与年龄相关的疼痛感知变化和认知障碍使得主观症状的评估变得困难。结合药物和非药物治疗的多学科疼痛管理方案已被证明对老年患者有效。镇痛药的选择需要了解药物代谢、合并症和同时使用药物方面与年龄相关的变化。药物剂量的调整以及益处和风险的评估应针对每个个体进行量身定制。迫切需要更好的专业教育计划以及专门针对我们社区老年人需求的进一步专项研究。