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您请求的操作仅限于组中的用户:老年患者的疼痛管理管理老年人的持续性疼痛行为是一项复杂的任务，需要考虑该年龄组存在的多种合并症、多种药物作用和生理易感性。由于已发表文献研究方法的稀缺性和多样性，很难报道老年人疼痛神经科学教育(Pain Neuroscience Education, PNE)| Pain]的流行情况。关于这个年龄组的疼痛是增加还是减少，以及是否存在性别差异，文献中存在差异。有大量证据表明，在住宿护理环境中，疼痛的患病率较高。王晓明，王晓明，王晓明，王晓明，王晓明，王晓明，王晓明，王晓明。老年人疼痛治疗的临床研究进展。年龄和衰老。2013年3月,42:i1-57。[[止痛药|扑热息痛]]应被视为治疗急性和持续性疼痛的一线治疗方法[参考]Freo U, Ruocco C, Valerio A, Scagnol I, Nisoli E.扑热息痛:指南推荐回顾。临床医学杂志。2021年7月31日;10(15):3420。，特别是肌肉骨骼起源，由于其良好的疗效和几乎没有绝对禁忌症。然而，重要的是“不能超过每小时4克的最大日剂量”。 '''Non-steroidal anti-inflammatory drugs (NSAIDs)''' should be used with caution with older people. The recommendation is that the lowest dose should be provided, for the shortest duration. For elderly people taking NSAIDs, they should also be prescribed a '''proton pump inhibitor (PPI)''' to reduce the incidence of stomach ulcers. NSAIDS are associated with gastrointestinal, renal and cardiovascular side effects, and drug–drug and drug–disease interactions. It is important for older people taking NSAIDs to be routinely monitored. NSAIDs can also increase the risk of falls, increase geriatric psychiatric events, and increase the risk of stroke. These risks and benefits should be balanced carefully in individual patients to optimize overall outcomes, especially in the elderly.Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772852/ A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly]. Aging and disease. 2018 Feb;9(1):143. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772852/ (last accessed 5.8.2019) NSAIDs have also been linked with impairment in bone healing. A systematic review conducted by Marquez-Lara et al. state that there is no consensus on whether they should be recommended post orthopaedic surgery .Marquez-Lara A, Hutchinson ID, Nuñez Jr F, Smith TL, Miller AN. Nonsteroidal anti-inflammatory drugs and bone-healing: a systematic review of research quality. Jbjs reviews. 2016 Mar 29;4(3). [[Opioids|Opioid]] therapy may be considered for patients with moderate or severe pain, particularly if the pain is causing functional impairment or is reducing their quality of life. When this form of analgesia is used it is important that regimes are individualised and monitored carefully. Side effects of opioids include nausea, vomiting and constipation which should be anticipated and suitable prophylaxis provided. '''Tricyclic antidepressants and anti-epileptic drugs''' are effective in the management of neuropathic pain. Intolerance to the medication and the occurrence of side effects limit their use in an older population. [[Therapeutic Corticosteroid Injection|Intra-articular corticosteroid injections]] in [[osteoarthritis]] of the [[knee]] is effective short term analgesia with a small risk of complications or joint damage. Intra-articular hyaluronic acid is effective and free of systemic adverse effects. It should be considered in patients. Current evidence suggests that intra-articular hyaluronic has a longer effect than intra-articular steroids but has a slower onset of action. Epidural steroid injections in the management of sciatica is not recommended due to conflicting evidence and the lack of larger studies. [[Exercise and Activity in Pain Management|Exercise]], [[Manual Therapy]], [[Acupuncture]], [[Transcutaneous Electrical Nerve Stimulation (TENS)]], [[Massage]] and psychological approaches are non-pharmacological approaches to pain relief which are well supported by the literature. These modalities should be considered in parallel with drug therapy. {{#ev:youtube|PkYafjpwA38|400}}

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