Unit of Geriatrics, Research Hospital of Rome, Italian National Research Centre on Aging (INRCA), Rome, Italy.
Drugs Aging. 2009 Dec;26 Suppl 1:63-73. doi: 10.2165/11534670-000000000-00000.
Chronic pain occurs in 45-85% of the geriatric population and the need to treat chronic pain is growing substantially. Unfortunately, treatment for chronic pain is not always correctly targeted, which leads to a reduced quality of life, with decreased socialization, depression, sleep disturbances, cognitive impairment, disability and malnutrition. Considering these consequences, healthcare professionals should aim at improving the diagnosis and treatment of chronic pain in older persons. One of the most important limitations in achieving successful pain management is that older people are not aware that pain management options exist or medications for pain, such as opioids, have associated benefits and adverse effects. Importantly, opioids do not induce any organ failure and if adequately used at the right dosage may only present some predictable and preventable adverse effects. Treating and controlling chronic pain is essential in elderly patients in order to maintain a good quality of life and an active role in both the family and society. To date there are only a few randomized clinical trials testing opioid therapy in elderly patients, and the aim of the present review is to highlight the efficacy and tolerability of opioid use through a literature search strategy in elderly people with chronic non-cancer pain.
慢性疼痛在老年人群体中的发生率为 45-85%，且对慢性疼痛的治疗需求正在大幅增长。不幸的是，慢性疼痛的治疗并非总是能够准确针对病因，这会导致生活质量下降，社交活动减少、抑郁、睡眠障碍、认知功能障碍、残疾和营养不良。鉴于这些后果，医疗保健专业人员应致力于改善老年人的慢性疼痛诊断和治疗。在实现成功的疼痛管理方面，最重要的限制之一是老年人不知道存在疼痛管理选择，或者疼痛药物（如阿片类药物）具有相关的益处和不良反应。重要的是，阿片类药物不会导致任何器官衰竭，如果在正确的剂量下使用，可能只会出现一些可预测和可预防的不良反应。治疗和控制慢性疼痛对老年患者至关重要，以维持良好的生活质量和在家庭和社会中保持积极的角色。迄今为止，只有少数随机临床试验测试了老年患者的阿片类药物治疗，本综述的目的是通过对慢性非癌性疼痛的老年人群进行文献检索策略，强调阿片类药物使用的疗效和耐受性。
