Open AccessThe Role of Opioids in Pain Management in Elderly Patients with Chronic Kidney Disease: A Review Article
Author(s) -
Sanam Dolati,
Faezeh Tarighat,
Fariba Pashazadeh,
Kavous Shahsavarinia,
Saina Gholipouri,
Hassan Soleimanpour
Publication year - 2020
Publication title -
anesthesiology and pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.438
H-Index - 26
eISSN - 2228-7531
pISSN - 2228-7523
DOI - 10.5812/aapm.105754
Subject(s) - medicine , oxycodone , hydromorphone , tramadol , kidney disease , chronic pain , opioid , pain ladder , acetaminophen , methadone , buprenorphine , analgesic , intensive care medicine , anesthesia , physical therapy , receptor
: Chronic kidney disease (CKD) is a global public health problem. Pain is one of the most generally experienced symptoms by CKD patients. Pain management is a key clinical activity; nonetheless, insufficient pain management by health professionals keeps it up. Opioids as pain relievers are a class of naturally-derived and synthetic medications. They act through interactions with receptors in peripheral nerves. Numerous pharmacokinetic alterations happen with aging that influence drug disposition, metabolism, and quality of life. Acetaminophen alone, or combined with low-potency opioid dose is regarded as the safest pain-relieving choice for CKD. Morphine and codeine are probably eluded in renal impairment patients and used with excessive carefulness. Tramadol, oxycodone, and hydromorphone can be used by patient monitoring, while methadone, transdermal fentanyl, and buprenorphine seem to be safe to use in older non-dialysis patients with renal impairment. Consistent with the available literature, the main aim of this review was to explore the occurrence of chronic pain and its opioid treatment in CKD patients. According to this review, more and well-made randomized controlled trials are necessary to find appropriate opioid doses and explore the occurrence of side effects.