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Is oxycodone/naloxone effective and safe in managing chronic pain of a fragile elderly patient with multiple skin ulcers of the lower limbs? A case report.

Guerriero F, Maurizi N, Francis M, Sgarlata C, Ricevuti G, Rondanelli M, Perna S, Rollone M - Clin Interv Aging (2015)

Bottom Line: However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids.In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients.Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, Pavia, Italy ; Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, Pavia, Italy.

ABSTRACT
Skin ulcers are a common issue in the elderly, as physiological loss of skin elasticity, alterations in microcirculation, and concomitant chronic diseases typically occur in advanced age, thereby predisposing to these painful lesions. Wound-related pain is often associated with skin ulcers and negatively impacts both the patient's quality of life and, indirectly, wound healing. Pain management is an ongoing issue in the elderly, and remains underestimated and under-treated in this fragile population. Recent guidelines suggest the use of opioids as the frontline treatment of moderate and severe pain in nononcological pain in the elderly. However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids. This case report describes an elderly diabetic patient with multiple ulcers of the lower limbs suffering wound-related pain. In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients. Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy.

No MeSH data available.


Related in: MedlinePlus

Ulcers of the lower limb at baseline, on admission.
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f1-cia-10-1283: Ulcers of the lower limb at baseline, on admission.

Mentions: The patient, CA, an 82-year-old female, suffering from type II diabetes mellitus for over 20 years complicated by peripheral neuropathy and arteriopathy, came to our attention presenting painful skin ulcers of the lower extremities (Figure 1, day 0 on admission). She was under basal–bolus scheme insulin, and on admission, glycemic values were somewhat uncontrolled (HbA1c 55 mmol/mol, fasting glucose 180 mg/dL). Despite the ongoing analgesic treatment (acetaminophen 3,000 mg daily), pain control was poor and wound treatment was strongly limited by the intense pain. She had also been prescribed tramadol by her general practitioner, stopped early due to nausea and vomiting. On admission, OXN-PR 5/2.5 mg bid (twice a day) was started, and acetaminophen was stopped.


Is oxycodone/naloxone effective and safe in managing chronic pain of a fragile elderly patient with multiple skin ulcers of the lower limbs? A case report.

Guerriero F, Maurizi N, Francis M, Sgarlata C, Ricevuti G, Rondanelli M, Perna S, Rollone M - Clin Interv Aging (2015)

Ulcers of the lower limb at baseline, on admission.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4536765&req=5

f1-cia-10-1283: Ulcers of the lower limb at baseline, on admission.
Mentions: The patient, CA, an 82-year-old female, suffering from type II diabetes mellitus for over 20 years complicated by peripheral neuropathy and arteriopathy, came to our attention presenting painful skin ulcers of the lower extremities (Figure 1, day 0 on admission). She was under basal–bolus scheme insulin, and on admission, glycemic values were somewhat uncontrolled (HbA1c 55 mmol/mol, fasting glucose 180 mg/dL). Despite the ongoing analgesic treatment (acetaminophen 3,000 mg daily), pain control was poor and wound treatment was strongly limited by the intense pain. She had also been prescribed tramadol by her general practitioner, stopped early due to nausea and vomiting. On admission, OXN-PR 5/2.5 mg bid (twice a day) was started, and acetaminophen was stopped.

Bottom Line: However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids.In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients.Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, Pavia, Italy ; Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, Pavia, Italy.

ABSTRACT
Skin ulcers are a common issue in the elderly, as physiological loss of skin elasticity, alterations in microcirculation, and concomitant chronic diseases typically occur in advanced age, thereby predisposing to these painful lesions. Wound-related pain is often associated with skin ulcers and negatively impacts both the patient's quality of life and, indirectly, wound healing. Pain management is an ongoing issue in the elderly, and remains underestimated and under-treated in this fragile population. Recent guidelines suggest the use of opioids as the frontline treatment of moderate and severe pain in nononcological pain in the elderly. However, due to the concerns of adverse reactions, drug interactions, and addiction, clinicians frequently hesitate to prescribe opioids. This case report describes an elderly diabetic patient with multiple ulcers of the lower limbs suffering wound-related pain. In our report, oxycodone/naloxone has proved to be an effective and safe drug, providing pain relief as well as increased compliance when redressing wounds and faster healing compared to that in similar patients. Our case provides anecdotal evidence, supported by other studies, to justify future, larger studies on chronic pain using this therapy.

No MeSH data available.


Related in: MedlinePlus