Skip to main content
SpringerLink
Log in

Pain Management

  • Chapter
Geriatric Anesthesiology

Abstract

The United States senior population is expected to double over the next 30 years (www.agingstats.gov). According to the latest data from the National Center for Health Statistics, 40.3 million inpatient surgical procedures were performed in the United States in 1996, followed closely by 31.5 million outpatient surgeries. These statistics are from 1996 and although the ratio of outpatient to inpatient procedures may have changed in the past 10 years, the total number of surgical procedures per year has not diminished. And certainly, the elderly undergo a disproportionate number of surgical procedures compared with younger age groups. Therefore, acute pain secondary to surgery will continue to be a significant problem for physicians.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cleeland C. Undertreatment of cancer pain in elderly patients. JAMA 1998;279(23):1914–1915.

    Article  PubMed  CAS  Google Scholar 

  2. Ferrell BA, Ferrell BR, Osterweil D. Pain in the nursing home. J Am Geriatr Soc 1990;38:409–414.

    PubMed  CAS  Google Scholar 

  3. Ferrell BA. Pain management in elderly people. J Am Geriatr Soc 1991;39:64–73.

    PubMed  CAS  Google Scholar 

  4. Chevlen E. Optimizing the use of opioids in the elderly population. Am J Pain Manage Suppl 2004;14(2):19S–24S.

    Google Scholar 

  5. Otis J, McGeeney B. Managing pain in the elderly. Clin Geriatr 2001;9:82–88.

    Google Scholar 

  6. Fine P. Difficulties and challenges in the treatment of chronic pain in the older adult. Am J Pain Manage 2004;14(2):2S–8S.

    Google Scholar 

  7. Parmelee PA, Katz IR, Lawton MP. The relation of pain to depression among institutionalized aged. J Gerontol 1991; 46:15–21.

    Google Scholar 

  8. Williamson G, Schulz RL. Pain, activity restriction, and symptoms of depression among community-residing elderly adults. J Gerontol 1992;47:367–372.

    Google Scholar 

  9. Casten R, Parmelee P, Kleban M, et al. The relationships among anxiety, depression, and pain in a geriatric institutionalized sample. Pain 1995;61:271–276.

    Article  PubMed  CAS  Google Scholar 

  10. Gaston-Johansson F, Johansson F, Johansson C. Pain in the elderly: prevalence, attitudes and assessment. Nurs Home Manage 1996;4(11):325–331.

    Google Scholar 

  11. Gaston-Johansson F, Johansson F, Johansson N. Undertreatment of pain in the elderly: causes and prevention. Ann Long-Term Care 1999;7(5):190–196.

    Google Scholar 

  12. Postone N. Alexithymia in chronic pain patients. Gen Hosp Psychiatry 1986;8:163–167.

    Article  PubMed  CAS  Google Scholar 

  13. Gibson S, Ferrell M. A review of age differences in the neurophysiology of nociception and the perceptual experience of pain. Clin J Pain 2004;20(4):227–239.

    Article  PubMed  Google Scholar 

  14. Shin S, Eisenach J. Peripheral nerve injury sensitizes the response to visceral distension but not its inhibition by the antidepressantMilnacipran. Anesthesiology 2004;100(3): 671–675.

    Article  PubMed  CAS  Google Scholar 

  15. Fine P. Pharmacological management of persistent pain in older patients. Clin J Pain 2004;20(4):220–226.

    Article  PubMed  Google Scholar 

  16. Zukerman LA, Ferrante FM. Nonopioid and opioid analgesics. In: Ashburn MA, Rice LJ, eds. The Management of Pain. New York: Churchill-Livingstone; 1998: 111–140.

    Google Scholar 

  17. Auburn F, Monsel S, Langeron O, et al. Postoperative titration of intravenous morphine in the elderly patient. Anesthesiology 2002;96(1):17–23.

    Article  Google Scholar 

  18. Hagen NA, Elwood T, Ernst S. Cancer pain emergencies: a protocol for management. J Pain Symptom Manage 1997; 14(1):45–50.

    Article  PubMed  CAS  Google Scholar 

  19. Cook D, Rooke A. Priorities in perioperative geriatrics. Anesth Analg 2003;96:1823–1836.

    Article  PubMed  Google Scholar 

  20. Dyer C, Ashton C. Postoperative delirium: a review of 80 primary data-collection studies. Arch Intern Med 1995;155(5):461–465.

    Article  PubMed  CAS  Google Scholar 

  21. Gustafson Y, Berggren D, Brännström B, et al. Acute confusional states in elderly patients treated for femoral neck fracture. J Am Geriatr Soc 1988;36:525–530.

    PubMed  CAS  Google Scholar 

  22. Gagliese L, Jackson M, Ritvo P, et al. Age is not an impediment to effective use of patient controlled analgesia by surgical patients. Anesthesiology 2000;93(3):601–610.

    Article  PubMed  CAS  Google Scholar 

  23. Mann C, Pouzeratte Y, Bocarra G, et al. Comparison of intravenous or epidural patient-controlled analgesia in the elderly after major abdominal surgery. Anesthesiology 2000;92(2):433–441.

    Article  PubMed  CAS  Google Scholar 

  24. Carli F, Phil M, Mayo N, et al. Epidural analgesia enhances functional exercise capacity and health related quality of life after colonic surgery. Results of a randomized trial. Anesthesiology 2002;97(3):540–549.

    Google Scholar 

  25. Jacox A, Carr DB, Payne R, et al. Management of cancer pain. Clinical practice guideline no. 9. AHCPR Publication No. 94-0592. Rockville, MD: Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service; 1994.

    Google Scholar 

  26. Weissman DE, Haddox JD. Opioid pseudoaddiction-an iatrogenic syndrome. Pain 1989;36:363–366.

    Article  PubMed  CAS  Google Scholar 

  27. Lasagna L, Beecher H. Optimal dose of morphine. J Am Med Assoc 1954;156(3):230–234.

    PubMed  CAS  Google Scholar 

  28. Gammaitoni A, Fine P, Alvarez N, et al. Clinical application of opioid equianalgesic data. Clin J Pain 2003;19(5):286–297.

    Article  PubMed  Google Scholar 

  29. Supernaw J. CYP2D6 and the efficacy of codeine-like drugs. Am J Pain Manage 2001;11(1):30–31.

    Google Scholar 

  30. Fishbain DA, Fishbain D, Lewis J, et al. Genetic testing for enzymes of drug metabolism: does it have clinical utility for pain medicine at the present time? A structured Review. Pain Med 2004;5(1):81–93.

    Article  PubMed  Google Scholar 

  31. Morley J. New perspectives in our use of opioids. Pain Forum 1999;8(4):200–205.

    Google Scholar 

  32. Quality of Life Matters Bulletin 2004;6(1). Published by Quality of Life Publishing Co. Tel: 1-877-513-0099.

    Google Scholar 

    Google Scholar 

  33. Teno J, Clarridge B, Casey V, et al. Family perspectives on end-of-life care at the last place of care. JAMA 2004; 291(1):88–93.

    Article  PubMed  CAS  Google Scholar 

  34. Sveticic G, Gentilini A, Eichenberger U, et al. Combinations of morphine with ketamine for patient-controlled analgesia. A new optimization method. Anesthesiology 2003;98(5): 1195–1205.

    Article  PubMed  CAS  Google Scholar 

  35. Berger JM, Ryan A, Vadivelu N, et al. Use of ketaminefentanyl-midazolam infusion for the control of symptoms in terminal life care. Am J Hosp Palliat Care 2000;17(2): 127–136.

    Article  PubMed  CAS  Google Scholar 

  36. Kellett J. Acute soft tissue injuries—a review of the literature. Med Sci Sports Exerc 1986;18:489–500.

    PubMed  CAS  Google Scholar 

  37. Vieth R, Raskind M, Caldwell J, et al. Cardiovascular effects of tricyclic antidepressants in depressed patients with chronic heart disease. N Engl J Med 1982;306:954–959.

    Google Scholar 

  38. Greisen J, Juhl C, Grofte T, et al. Acute pain induces insulin resistance in humans. Anesthesiology 2001;95(3):578–584.

    Article  PubMed  CAS  Google Scholar 

  39. Paqueron X, Boccara G, Bendahou M, et al. Brachial plexus nerve block exhibits prolonged duration in the elderly. Anesthesiology 2002;97(5):1245–1249.

    Article  PubMed  Google Scholar 

  40. Andersen G, Vestergaard K, Ingeman-Nielsen M, et al. Incidence of central post-stroke pain. Pain 1995;61:187–193.

    Article  PubMed  CAS  Google Scholar 

  41. Jensen TS, Rasmussen P. Phantompain. In:Wall PD, Melzack R, eds. Textbook of Pain. Edinburgh: Churchill-Livingstone; 1994:651–665.

    Google Scholar 

  42. Beri’c A, Dimitrijevi’c MA, Lindblom U. Central dysesthesia syndrome in spinal cord injury patients. Pain 1988;34: 109–116.

    Article  PubMed  CAS  Google Scholar 

  43. Melton LJ, Dyck PJ. Epidemiology. In: Dyck PJ, Thomas PK, Asbury AK, et al., eds. Diabetic Neuropathy. Philadelphia: Saunders; 1987:27–35.

    Google Scholar 

  44. Lipson S. Spinal-fusion surgery—advances and concerns. N Engl J Med 2004;350(7):643–644.

    Article  PubMed  CAS  Google Scholar 

  45. Deyo RA, Nachemson A, Mirza SK. Spinal-fusion surgerythe case for restraint. N Engl J Med 2004;350(7):722–726.

    Article  PubMed  CAS  Google Scholar 

  46. Cohen SP, Larkin TM, Barna SA, et al. Lumbar discography: a comprehensive review of outcomes studies, diagnostic accuracy, and principles. Reg Anesth Pain Med 2005;30(2):163–183.

    Article  PubMed  Google Scholar 

  47. Singh V, Piryani C, Liao K. Role of percutaneous disc decompression using coblation in managing chronic discogenic low back pain: a prospective, observational study. Pain Phys 2004;7:419–425.

    Google Scholar 

  48. Deer T, Chapple I, Classen A, et al. Intrathecal drug delivery for treatment of chronic low back pain: report from the national outcomes registry for low back pain. Pain Med 2004;5(1):6–13.

    Article  PubMed  Google Scholar 

  49. Faclier G, Kay J. Cervical facet radiofrequency neurotomy. Tech Reg Anesth Pain Manage 2000;4(3):120–125.

    Article  Google Scholar 

  50. Dreyfuss P, Halbrook B, Pauza K, et al. Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine 2000;25:1270–1277.

    Article  PubMed  CAS  Google Scholar 

  51. Manchikanti L. Chronic low back pain in the elderly: Part I. Am J Pain Manage 1997;7(3):104–117.

    Google Scholar 

  52. Manchikanti L. Chronic low back pain in the elderly: Part II. Am J Pain Manage 1997;7(4):133–145.

    Google Scholar 

  53. Mathis JM, Barr JD, Belkoff SM, et al. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 2001;22: 373–381.

    PubMed  CAS  Google Scholar 

  54. Sesay M, Dousset V, Liguoro D, et al. Intraosseous lidocaine provides effective analgesia for percutaneous vertebroplasty of osteoporotic fractures. Can J Anesth 2002;49:137–143.

    Article  PubMed  Google Scholar 

  55. Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 1997;18:1897–1904.

    PubMed  CAS  Google Scholar 

  56. McKiernan F, Faciszewski T, Jensen R. Quality of life following vertebroplasty. J Bone Joint Surg 2004;86(12): 2600–2606.

    PubMed  Google Scholar 

  57. Dougherty P, Staats P. Intrathecal drug therapy for chronic pain: from basic science to clinical practice. Anesthesiology 1999;91(6):1891–2003.

    Article  PubMed  CAS  Google Scholar 

  58. Toliver KT, Berger JM, Pardo ES. Review of herpes zoster. Semin Anesth 1997;16(2):127–131.

    Google Scholar 

  59. Manabe H, Dan K, Hirata K, et al. Optimum pain relief with continuous epidural infusion of local anesthetic shortens the duration of zoster-associated pain. Clin J Pain 2004; 20(5):302–308.

    Article  PubMed  Google Scholar 

  60. de Moragas JM, Kierland RR. The outcome of patients with herpes zoster. AMA Arch Derm 1957;75:193–196.

    Google Scholar 

  61. Pardo ES, Berger JM, Toliver KT. Post herpetic neuralgia. Semin Anesth 1997;16(2):132–135.

    Google Scholar 

  62. Kotani N, Kushikata T, Hashimoto H, et al. Intrathecal methylprednisolone for intractable postherpetic neuralgia. N Engl J Med 2000;343(21):1514–1519.

    Article  PubMed  CAS  Google Scholar 

  63. Abram S. Treatment of lumbosacral radiculopathy with epidural steroids: clinical concepts and commentary. Anesthesiology 1999;91(6):1937–1941.

    Article  PubMed  CAS  Google Scholar 

  64. Rowlingson J. Epidural steroids in treating failed back surgery syndrome. Anesth Analg 1999;88:240–242.

    Article  PubMed  CAS  Google Scholar 

  65. Fredman B, Nun M, Zohar E, et al. Epidural steroids for treating “failed-back surgery syndrome.” Is fluoroscopy really necessary? Anesth Analg 1999;88:367–372.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Jack M. Berger MD, PhD (Clinical Professor)

Authors
  1. Jack M. Berger MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Surgery, and Geriatrics and Adult Development , Mount Sinai School of Medicine, New York, NY, USA

    Jeffrey H. Silverstein MD (Professor, Vice Chairman for Research, Associate Dean for Research) (Professor, Vice Chairman for Research, Associate Dean for Research)

  2. Department of Anesthesiology, University of Washington and the Veterans Affairs Puget Sound Health Care System, Seattle, WA

    G. Alec Rooke MD, PhD (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine) (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine)

  3. Harvard Medical School Beth Israel Deaconess Medical Center, Boston, MA, USA

    G. Alec Rooke MD, PhD (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine) (Professor and Visiting Professor of Anesthesia, Critical Care, and Pain Medicine)

  4. College of Medicine Department of Anesthesiology/College of Medicine, Medical University of South Carolina, Charleston, SC, USA

    J. G. Reves MD (Vice President for Medical Affairs, Dean) (Vice President for Medical Affairs, Dean)

  5. Salt Lake City, UT, USA

    Charles H. McLeskey MD

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Berger, J.M. (2008). Pain Management. In: Silverstein, J.H., Rooke, G.A., Reves, J.G., McLeskey, C.H. (eds) Geriatric Anesthesiology. Springer, New York, NY. https://doi.org/10.1007/978-0-387-72527-7_21

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-72527-7_21

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-72526-0

  • Online ISBN: 978-0-387-72527-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation