Tratamiento del dolor en el anciano: Opioides y adyuvantes

Abstract

There is a small number of primary studies relating to opioid use in older people. In carefully selected and monitored patients, opioids may provide effective pain relief as part of comprehensive pain management strategy. Use of strong opioids in the management of chronic, severe cancer and non-cancer pain in older people has been reviewed. Studies have demonstrated short-term efficacy in persistent musculoskeletal pain and various neuropathic pains. However, longer-term efficacy and safety data are lacking. Some adjuvant drugs should be considered for older people with neuropathic. Although tricyclic antidepressants have good efficacy, anticholinergic side effects are often problematic for older people. Anti-epileptic drugs such as gabapentin or pregabalin, are effective for neuropathic pain and are probably better tolerated. Topical administration may have improved tolerability than other routes of administration and may be preferable for elderly.