Section of Geriatrics and Palliative Medicine, University of Chicago, 5841 S.Maryland avenue, Chicago, IL 60537, USA.
VITAS Healthcare, 201 South Biscayne Boulevard Miami, Miami, FL 33131, USA.
Med Clin North Am. 2015 Mar;99(2):337-50. doi: 10.1016/j.mcna.2014.11.007. Epub 2014 Dec 24.
Persistent pain in older adults is common, and associated with substantial morbidity. Optimal management starts with assessment, including pain presence, intensity, characteristics, and interference; painful conditions; pain behaviors; pain-related morbidity; pain treatments; and coping style. Treatment incorporates analgesics demonstrated to decrease pain and improve a patient's sense of well-being. The World Health Organization's 3-step pain ladder is widely accepted and adopted for selecting analgesics among patients with non-cancer pain. Shared decision making is essential to balance the benefits and burdens of analgesics. This article reviews pain assessment/management for older adults, focusing on commonly used analgesics.
老年人持续性疼痛很常见,且与较大的发病率相关。最佳管理始于评估,包括疼痛的存在、强度、特征和干扰;疼痛状况;疼痛行为;与疼痛相关的发病率;疼痛治疗;和应对方式。治疗包括已证明可减轻疼痛并改善患者幸福感的镇痛药。世界卫生组织的三步止痛阶梯在非癌痛患者中选择镇痛药被广泛接受和采用。共同决策对于平衡镇痛药的益处和负担至关重要。本文回顾了老年人的疼痛评估/管理,重点介绍了常用的镇痛药。