Pain (Patient) (cont.)
IN THIS ARTICLE
Invasive Interventions to Relieve Pain
Less invasive methods should be used for relieving pain before trying invasive treatment. Some patients, however, may need invasive therapy.
A nerve block is the injection of either a localanesthetic or a drug that inactivates nerves to control otherwise uncontrollable pain. Nerve blocks can be used to determine the source of pain, to treat painful conditions that respond to nerve blocks, to predict how the pain will respond to long-term treatments, and to prevent pain following procedures.
Surgery can be performed to implant devices that deliver drugs or electrically stimulate the nerves. In rare cases, surgery may be done to destroy a nerve or nerves that are part of the pain pathway.
Management of Procedural Pain
Many diagnostic and treatment procedures are painful. Pain related to procedures may be treated before it occurs. Local anesthetics and short-acting opioids can be used to manage procedure-related pain, if enough time is allowed for the drug to work. Anti-anxiety drugs and sedatives may be used to reduce anxiety or to sedate the patient. Treatments such as imagery or relaxation are useful in managing procedure-related pain and anxiety.
Patients usually tolerate procedures better when they know what to expect. Having a relative or friend stay with the patient during the procedure may help reduce anxiety.
Patients and family members should receive written instructions for managing the pain at home. They should receive information regarding whom to contact for questions related to pain management.
Treating Older Patients
Older patients are at risk for under-treatment of pain because their sensitivity to pain may be underestimated, they may be expected to tolerate pain well, and misconceptions may exist about their ability to benefit from opioids. Issues in assessing and treating cancer pain in older patients include the following:
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