Assessment of pharmacologic pain management modalities for patients on hemodialysis

Ian P. Rios, Lenora Smith, Daniel R. Mead
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Abstract

Objective: The aim of this project was to assess the change in pain level for hospitalized patients on hemodialysis when using non-opioid medications alone compared to opioid medications alone to establish support for a clinical pain management model that would provide acute pain management guidance for patients on hemodialysis.Methods: This was a non-interventional survey completed at an acute care hospital in Chicago, IL. Patients over the age of 18 on hemodialysis reporting acute pain completed the Short Form McGill Pain Questionnaire-2 on day one and day three of  hospitalization to assess pain levels over a three-day period. Results: The results demonstrate a decrease in total pain for patients using non-opioid medications and opioid medications; however, there is no statistically significant decrease in total pain scores between participants using non-opioid medications alone versus opioid medications alone (p = .743).Conclusions: Patients in the non-opioid group perceived their pain management to improve between day one and day three; however, their pain management did not improve to the degree that opioid medications provided. Care should be taken when dosing opioid medications for patients on hemodialysis given the patients’ decreased renal function.
评估血液透析患者的药物止痛方法
目标:本项目旨在评估住院血液透析患者在单独使用非阿片类药物与单独使用阿片类药物时疼痛程度的变化,从而为临床疼痛管理模式提供支持,为血液透析患者提供急性疼痛管理指导:这是一项在伊利诺伊州芝加哥市一家急症护理医院完成的非干预性调查。年龄在 18 岁以上、报告有急性疼痛的血液透析患者在住院第一天和第三天填写了 Short Form McGill Pain Questionnaire-2,以评估三天内的疼痛程度。结果显示结果表明,使用非阿片类药物和阿片类药物的患者的总疼痛程度均有所减轻;然而,单独使用非阿片类药物与单独使用阿片类药物的参与者之间的总疼痛评分没有统计学意义上的显著降低(P = .743):结论:非阿片类药物组患者认为他们的疼痛控制情况在第一天到第三天之间有所改善;但是,他们的疼痛控制情况并没有改善到阿片类药物所能提供的程度。考虑到血液透析患者的肾功能减退,在给他们服用阿片类药物时应小心谨慎。
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