老年持续疼痛评价和药物治疗

根据美国老年医学会2009年颁布的"老年持续疼痛的药物治疗"指南的要求,总结认知正常或障碍的老年患者疼痛评价方法,以及镇痛药的使用特点.普通持续疼痛首选对乙酰氨基酚;非甾体抗炎药只能短期使用,并密切观察胃肠及心血管副反应;对神经痛患者可加用神经活性药物和维生素D等辅助治疗.

Assessment and Management of Persistent Pain in Older Persons

American Geriatrics Society has issued an updated guideline for treating persistent pain in patients aged 75 and older. Based on the guideline and others, this article summarizes information on the assessment of pain in older patients with cognition intact or impaired, as well as the newer pharmacological approaches to managing persistent pain in the older population. Dueing to its greater safety than traditional non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen is recommended as first-line therapy for pain. NSAIDs can only be used in short-term, and need close observation for gastrointestinal and cardiovascular side effects. Other psychoactive medications and vitamin D for neuropathic pain are provided as adjuvant therapy.