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Pain management in the elderly 

Pain management in the elderly
Pain management in the elderly

Andrew Severn

and Joanne McGuire

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date: 12 July 2020

This chapter focuses on acute pain management in the elderly, its assessment, choices of drugs, and postoperative pain control. The difficult assessment of pain in a cognitively impaired patient is reviewed and the relative merits of the variety of assessment tools discussed. The detailed assessment of verbal (self-rating) and observational (behavioural) tools is comprehensive. The utility of specific analgesic drugs in the elderly is then reviewed, including paracetamol and non-steroidal anti-inflammatory drugs. The use of the latter is controversial in the elderly and the reasons for this are discussed. Opioid drugs in the elderly are reviewed and the very limited place of pethidine highlighted. Acute postoperative pain control is then covered, including the role of acute pain services. Complications from inadequate pain relief are explored, and finally, methods of providing pain relief by local anaesthetic blockade are reviewed.

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