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Pain Control in the Elderly
- Narcotic pain relievers are often avoided in the elderly due to the concern of sedation, risk of falls and the concern of them causing delirium.
- Delirium can cause significant morbidity and mortality and can be difficult to differentiate between the sedation and mild confusion that often occurs with opioid dose escalation.
- However, delirium has been shown to occur more commonly as a result of the under treatment of pain rather than as an opioid adverse effect.
So the take home lesson for this pearl is that the elderly have a lower risk of delirium if their pain is treated appropriately.
References
Duggleby W, Lander J: Cognitive status and postoperative pain: older adults. J Pain Symptom Manage 1994; 9: 19-27.
Lynch EP, Lazor MA, Gellis JE, Orav J, Goldman L, Marcantonio ER: The impact of postoperative pain on the development of postoperative delirium. Anesth Analg 1998; 86: 781-785.