Should We Treat Pain in the Elderly Palliative Care Cancer Patients Differently?

Golčić, Marin; Dobrila-Dintinjana, Renata; Golčić, Goran; Plavsic, Ivana; Gović-Golčić, Lidija; Belev, Berislav; Gajski, Domagoj; Rotim, Krešimir

doi:10.20471/acc.2020.59.03.01

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…52 Symptom management has received much attention, particularly the management of pain. [53][54][55] However, oral problems at the end of life have received less attention. An extremely common yet undermanaged oral problem can impact other symptoms, including both physical and psychological symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Oral conditions and other symptoms among older persons in long‐term care facilities during the end of life

Chung

Chen

Zhang

et al. 2022

Special Care in Dentistry

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Aims: The purpose was to examine the association between oral conditions and other symptoms in long‐term care facilities during the last days of life.Methods: A retrospective case‐control study approach was used in this study, with the Minimum Data Set (MDS, ver. 3.0 2015) that was maintained and administrated by the Centers for Medicare and Medicaid Services (CMS). Residents with oral conditions (n = 4304) were selected with any oral conditions (e.g., ulcers, inflamed/bleeding gums, mouth/facial pain). The control cases (n = 12 912) were selected using propensity analysis.Results: Oral conditions had significant impacts on depression, poor appetite, pain, shortness of breath, and constipation. Although no statistically significant differences in trouble sleeping, vomiting, internal bleeding, and dehydration were found between the cases with oral conditions and the control, more residents with oral conditions reported trouble sleeping and dehydration compared to the control.Conclusions: It is important to provide preventive and proactive intervention for oral conditions, not only to minimize the negative effects of oral conditions on other symptoms in long‐term care facilities, but also to share philanthropic support with people who might be suffering other symptoms due to oral conditions at the end of life.

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Section: Discussionmentioning

confidence: 99%

“…The key to palliative care is to optimize the management of troubling symptoms 52 . Symptom management has received much attention, particularly the management of pain 53–55 . However, oral problems at the end of life have received less attention.…”

Section: Discussionmentioning

confidence: 99%

Oral conditions and other symptoms among older persons in long‐term care facilities during the end of life

Chung

Chen

Zhang

et al. 2022

Special Care in Dentistry

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“…Especially elderly patients, their sensitivity to opioids is significantly increased. The demand for opioids in the elderly is lower, but the side effects are greater (9). Therefore, the dose adjustment of oxycodone in PCIA has become a challenge for elderly patients.…”

Section: Introductionmentioning

confidence: 99%

The optimal dose of oxycodone in PCIA after laparoscopic surgery for gastrointestinal cancer in elderly patients: A randomized controlled trial

et al. 2023

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ObjectiveTo explore the optimal bolus dose of oxycodone for patient controlled intravenous analgesia (PCIA) without background dose in elderly patients after laparoscopic surgery for gastrointestinal cancer.MethodsIn this prospective, randomized, double-blind, parallel-controlled study, we recruited patients aged 65 years or older. They underwent laparoscopic resection for gastrointestinal cancer and received PCIA after surgery. Eligible patients were randomly divided into 0.01, 0.02, or 0.03 mg/kg group according to the bolus dose of oxycodone in PCIA. The primary outcome was VAS scores of pain on mobilization at 48 h after surgery. Secondary endpoints included the VAS scores of rest pain, the total and effective numbers of press in PCIA, cumulative dose of oxycodone used in PCIA, the incidence of nausea, vomiting and dizziness, as well as patients’ satisfaction at 48 h after surgery.ResultsA total of 166 patients were recruited and randomly assigned to receive a bolus dose of 0.01 mg/kg (n = 55), 0.02 mg/kg (n = 56) or 0.03 mg/kg (n = 55) of oxycodone in PCIA. The VAS scores of pain on mobilization, the total and effective numbers of press in PCIA in 0.02 mg/kg group and 0.03 mg/kg group were lower than those in 0.01 mg/kg group (P < 0.05). Cumulative dose of oxycodone used in PCIA and patients’ satisfaction in 0.02 and 0.03 mg/kg groups were more than those in 0.01 mg/kg group (P < 0.01). The incidence of dizziness in 0.01 and 0.02 mg/kg groups was lower than that in 0.03 mg/kg group (P < 0.01). There were no significant differences in VAS scores of rest pain, the incidence of nausea and vomiting among three groups (P > 0.05).ConclusionFor elderly patients undergoing laparoscopic surgery for gastrointestinal cancer, 0.02 mg/kg bolus dose of oxycodone in PCIA without background infusion may be a better choice.

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Should We Treat Pain in the Elderly Palliative Care Cancer Patients Differently?

Cited by 2 publications

References 26 publications

Oral conditions and other symptoms among older persons in long‐term care facilities during the end of life

Oral conditions and other symptoms among older persons in long‐term care facilities during the end of life

The optimal dose of oxycodone in PCIA after laparoscopic surgery for gastrointestinal cancer in elderly patients: A randomized controlled trial

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