Pain Management Nursing
Volume 9, Issue 2 , Pages 66-72 , June 2008

Aging and Delirium: Too Much or Too Little Pain Medication?

  • Sherry Robinson, PhD, RNCS

      Affiliations

    • SIU School of Medicine, Springfield, Illinois
    • Corresponding Author InformationAddress correspondence to Sherry Robinson, PhD, RNCS, Assistant Professor, Department of Internal Medicine, SIU School of Medicine, P.O. Box 19636, Springfield, Illinois 62794-9636.
    • ,
  • Charlene Vollmer, BSN, RNBC

      Affiliations

    • Memorial Medical Center, Springfield, Illinois.
    • ,
  • Holly Jirka, MSN, RNBC

      Affiliations

    • Memorial Medical Center, Springfield, Illinois.
    • ,
  • Catherine Rich, BSN, RNBC

      Affiliations

    • Memorial Medical Center, Springfield, Illinois.
    • ,
  • Carol Midiri, RNBC

      Affiliations

    • Memorial Medical Center, Springfield, Illinois.
    • ,
  • Donna Bisby, RNBC

      Affiliations

    • Memorial Medical Center, Springfield, Illinois.

References 

  1. Agnoletti V, Ansaloni L, Catena F, Chattat R, De Cataldis A, Di Nino G, et al. Postoperative delirium after elective and emergency surgery: analysis and checking of risk factors (A study protocol). BMC Surgery. 2005;5:12–18
  2. AGS Panel on Persistent Pain in Old Persons. The management of persistent pain in older persons. Journal of the American Geriatrics Society. 2002;50:S205–S224
  3. Asher ME. Surgical considerations in the elderly. Journal of PeriAnesthesia Nursing. 2004;19(6):406–414
  4. Brauer C, Morrison RS, Silberzweig SB, Siu AL. The cause of delirium in patients with hip fracture. Archives of Internal Medicine. 2000;160:1856–1860
  5. Burns A, Gallagley A, Byrne J. Delirium. Journal of Neurology, Neurosurgery, & Psychiatry. 2004;75:362–367
  6. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases. 1987;40(5):373–383
  7. Crombez G, Eccleston C, Baeyens F, Eelen P. The disruptive nature of pain: an experimental investigation. Behavioral Research & Therapy. 1996;34(11/12):911–918
  8. Crombez G, Eccleston C, Baeyens F, Eelen P. Habituation and the interference of pain with task performance. Pain. 1997;70:149–154
  9. Eccleston C. Chronic pain and distraction: an experimental investigation into the role of sustained and shifting attention in the processing of chronic persistent pain. Behavioral Research and Therapy. 1995;33(4):3991–4405
  10. Ersek M, Cherrier MM, Overman SS, Irving GA. The cognitive effects of opioids. Pain Management Nursing. 2004;5(2):75–93
  11. Esper P, Heidrich D. Symptom clusters in advanced illness. Seminars in Oncology Nursing. 2005;21(1):20–28
  12. Everett B, Salamonson Y. Differences in postoperative opioid consumption in patients prescribed patient-controlled analgesia versus intramuscular injection. Pain Management Nursing. 2005;6(4):137–144
  13. Fong HK, Sands LP, Leung JM. The role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review. Anesthesia & Analgesia. 2006;102:1255–1266
  14. Grass JA. Patient-controlled analgesia. Anesthesiology & Analgesia. 2005;101:S44–S61
  15. Gaudreau J, Gagnon P, Harel F, Tremblay A, Roy M. Fast, systematic, and continuous delirium assessment in hospitalized patients; the nursing delirium screening scale. Journal of Pain and Symptom Management. 2005;29(4):368–375
  16. Inouye SK. Delirium in hospitalized older patients. Clinics in Geriatric Medicine. 1998;14:745–768
  17. Inouye SK. Delirium in older persons. The New England Journal of Medicine. 2006;354:1157–1165
  18. Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons: a predictive model and interrelationship with baseline vulnerability. Journal of the American Medical Association. 1996;275:852–857
  19. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The confusion assessment method: a new method for detection of delirium. Annals of Internal Medicine. 1990;113:941–948
  20. Inouye SK, Viscoli CM, Horwitz RI, Hurst LD, Tinetti ME. A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Annals of Internal Medicine. 1993;119:474–480
  21. Karp JF, Reynolds CF, Butters MA, Dew MA, Mazumdar S, Begley AE, et al. The relationship between pain and mental flexibility in older adult pain clinic patients. Pain Medicine. 2006;7(5):444–452
  22. Keita H, Geachan N, Dahmani S, Couderc E, Armand C, Quazza M, et al. Comparison between patient-controlled analgesia and subcutaneous morphine in elderly patients after total hip replacement. British Journal of Anaesthesia. 2003;90(1):53–57
  23. Lynch EP, Lazor MA, Gellis JE, Orav J, Goldman L, Marcantonio ER. The impact of postoperative pain on the development of postoperative delirium. Anesthesia & Analgesia. 1998;86:781–785
  24. Macintyre PE, Jarvis DA. Age is the best predictor of postoperative morphine requirements. Pain. 1996;64:357–364
  25. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: a randomized trial. Journal of the American Geriatrics Society. 2001;49:516–522
  26. Meagher DM. Delirium: optimizing management. British Medical Journal. 2001;322:144–149
  27. Milisen K, Foreman MD, Abraham IL, De Geest S, Godderis J, Vandermeulen E, et al. A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients. Journal of the American Geriatrics Society. 2001;49:523–532
  28. Morrison RS, Magaziner J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. Journal of Gerontology: Medical Sciences, 58A. 2003;58A:76–81
  29. Pisani MA, McNicoll L, Inouye SK. Cognitive impairment in the intensive care unit. Clinics of Chest Medicine. 2003;24:727–737
  30. Pompei P, Foreman M, Rudberg M, Inouye S, Braund V, Cassel C. Delirium in hospitalized older person: outcomes and predictors. Journal of the American Geriatric Society. 1994;42:809–815
  31. Rao SS, Cherukuri M. Management of hip fracture: The family physician's role. American Academy of Family Physicians. 2006;73(12):2195–2200
  32. Schuurmans MJ, Duursma SA, Shortridge-Baggett LM, Clevers G, Pel-Little R. Elderly patients with a hip fracture: the risk of delirium. Applied Nursing Research. 2003;16(2):75–84
  33. Vaurio LE, Sands LP, Wang Y, Mullen EA, Leung JM. Postoperativedelirium: the importance of pain and pain management. Anesthesia & Analgesia. 2006;102:1267–1273

PII: S1524-9042(07)00186-5

doi: 10.1016/j.pmn.2007.12.002

Pain Management Nursing
Volume 9, Issue 2 , Pages 66-72 , June 2008

Article Tools