Bicket Mark C, Mao Jianren
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Wang Ambulatory Care Center, 55 Fruit Street Gray-Bigelow 444, Boston, MA 02114, USA.
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Wang Ambulatory Care Center, 55 Fruit Street Gray-Bigelow 444, Boston, MA 02114, USA.
Anesthesiol Clin. 2015 Sep;33(3):577-90. doi: 10.1016/j.anclin.2015.05.011. Epub 2015 Jul 7.
This review summarizes existing evidence relevant to the epidemiology of chronic pain in older adults, age-related differences relevant to pain, pain assessment, and important considerations regarding pain management in later life. Features unique to pain assessment in older adults include the likelihood of multiple diagnoses contributing to chronic pain, the ability of older adults to self-report, including those with mild to moderate cognitive impairment, and recognition that some older adults with cognitive impairment may demonstrate various behaviors to communicate pain. Management is best accomplished through a multimodal approach, including pharmacologic and nonpharmacologic treatments, physical rehabilitation, and psychological therapies. Interventional pain therapies may be appropriate in select older adults, which may reduce the need for pharmacologic treatments.
本综述总结了与老年人慢性疼痛流行病学相关的现有证据、与疼痛相关的年龄差异、疼痛评估以及晚年疼痛管理的重要注意事项。老年人疼痛评估的独特特征包括导致慢性疼痛的多种诊断的可能性、老年人自我报告的能力，包括轻度至中度认知障碍者，以及认识到一些认知障碍的老年人可能会表现出各种行为来传达疼痛。通过多模式方法可以最好地实现疼痛管理，包括药物和非药物治疗、物理康复和心理治疗。介入性疼痛治疗可能适用于特定的老年人，这可能会减少药物治疗的需求。
