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Schmerztherapie im Alter: Besonderheiten und Empfehlungen

Pain treatment in old age: special features and recommendations

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Zusammenfassung

Hintergrund

Für ältere Schmerzpatienten ist ein gut abgestimmtes und umfassendes Management erforderlich, das die bestmögliche Schmerzlinderung bei möglichst weitgehender Vermeidung potenziell negativer Nebenwirkungen von Therapien sicherstellt.

Ziel der Arbeit

Beschreibung der Besonderheiten der Schmerztherapie bei älteren Patienten hinsichtlich allgemeiner beachtenswerter Grundregeln sowie Darstellung medikamentöser und nichtmedikamentöser Therapieverfahren.

Methoden

Es werden in der Arbeit die Besonderheiten der Schmerztherapie bei älteren Patienten beschrieben, Empfehlungen zum Analgetikaeinsatz bei Organdysfunktionen gegeben und Interaktionsprofile beschrieben. Darüber hinaus werden einzelne Substanzgruppen hinsichtlich ihres Einsatzes beim geriatrischen Patienten anhand rezenter Literatur beleuchtet.

Schlussfolgerungen

Ziele einer individualisierten Schmerztherapie bei älteren und hochbetagten Menschen sind eine Schmerzreduktion auf das jeweils angemessene Maß, Erhalt von Beweglichkeit und Mobilität sowie von Selbstständigkeit und Autonomie. Soziale Teilhabe und eine Verbesserung der Lebensqualität müssen im Mittelpunkt stehen.

Abstract

Background

For geriatric patients with chronic pain, a comprehensive well-coordinated pain management is pivotal to ensure the best possible pain relief and to minimize as far as possible preventable negative side effects of treatment.

Objective

Description of the difficulties in pain management of geriatric patients with respect to general basic rules that are worth paying attention to and presentation of pharmacological and non-pharmacological treatment options.

Methods

This article describes the special features of pain management in older patients and gives recommendations on the use of analgesics and potential drug interactions in geriatric patients with organ dysfunction. Furthermore, individual substance groups are described with respect to their use in geriatric patients based on the recent literature.

Conclusion

The aim of an individualized pain treatment in older and multimorbid patients is the relief of pain to an appropriate level, preservation of mobility, self-reliance and autonomy of each individual. The ability to participate in social activities as well as improvement in the quality of life need to be the focus of pharmacological and non-pharmacological treatment.

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Author information

Authors and Affiliations

  1. Abteilung für Akutgeriatrie/Remobilisation, Klinikum Klagenfurt am Wörthersee, Feschnigstraße 11, 9020, Klagenfurt am Wörthersee, Österreich

    Georg Pinter

  2. Landesklinikum Horn, Moorheilbad Harbach, Österreich

    Waltraud Stromer

  3. Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich

    Josef Donnerer

  4. Geyrhofer KG, Grein, Österreich

    Svetlana Geyrhofer

  5. Landesklinikum Stockerau, Stockerau, Österreich

    Burkhard Leeb

  6. Salzkammergut-Klinikum Vöcklabruck, Vöcklabruck, Österreich

    Nenad Mitrovic

  7. Krankenanstalt Rudolfstiftung Wien, Wien, Österreich

    Katharina Pils

  8. Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Österreich

    Ruldolf Likar

  9. LKH Wolfsberg, Wolfsberg, Österreich

    Ruldolf Likar

  10. Sigmund Freud Universität Wien, Wien, Österreich

    Ruldolf Likar

Authors
  1. Georg Pinter
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  2. Waltraud Stromer
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Corresponding author

Correspondence to Georg Pinter.

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Interessenkonflikt

G. Pinter, W. Stromer, J. Donnerer, S. Geyrhofer, B. Leeb, N. Mitrovic, K. Pils und R. Likar geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Pinter, G., Stromer, W., Donnerer, J. et al. Schmerztherapie im Alter: Besonderheiten und Empfehlungen. Z Gerontol Geriat 54, 605–610 (2021). https://doi.org/10.1007/s00391-020-01766-7

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  • DOI: https://doi.org/10.1007/s00391-020-01766-7

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