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Pain in the Elderly, Not What it Seems: Part 1

Agenda

Announcements

+ Roll Call

5 Minutes

Talk

+ Q&A

30 Minutes

Case Presentation

+ Discussion

45 Minutes

Wrap Up

+ Final Announcements

5 Minutes

Between Talk & Case there will be a Movement/Stretch Break

Note that speaker, case presenter, and/or hub member availability are factors determining if a session begins with the talk or the case. The case and talk shown above are in no particular order.


Talk

Sara Kelly, MD, MPH, FRCPC

Case Discussion

Patricia Poulin, C.Psych + Daniel James, MD, MA, FRCPC

Feedback


Session Resources

•GeriRx Files – online resource for prescribing practices (Canadian!) www.rxfiles.ca

•GeriMed Risk – non-profit virutal clinical service to optimize medications, physical & mental health conditions in older adults www.gerimedrisk.com

Jen’s Corner

https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698#Allodynia
Goebel A, Bisla J, Carganillo R, et al. A randomised placebo-controlled Phase III multicentre trial: low-dose intravenous immunoglobulin treatment for long-standing complex regional pain syndrome (LIPS trial). Southampton (UK): NIHR Journals Library; 2017 Nov. (Efficacy and Mechanism Evaluation, No. 4.5.) Appendix 3, Research diagnostic criteria (the ‘Budapest Criteria’) for complex regional pain syndrome. Available from: https://www-ncbi-nlm-nih-gov.proxy.lib.nosm.ca/books/NBK464482/
Colvin, L. A., Bull, F., & Hales, T. G. (2019). Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia. Lancet (London, England), 393(10180), 1558–1568. https://doi.org/10.1016/S0140-6736(19)30430-1

Lee, M., Silverman, S. M., Hansen, H., Patel, V. B., & Manchikanti, L. (2011). A comprehensive review of opioid-induced hyperalgesia. Pain physician, 14(2), 145–161.

Rome IV criteria for diagnosis of IBS: https://www.mdcalc.com/rome-iv-diagnostic-criteria-irritable-bowel-syndrome-ibs

http://www.criugm.qc.ca/fichier/pdf/BENZOeng.pdf

https://fpnotebook.com/surgery/exam/CrntsSgn.htm
Forgot: positive Carnett’s sign = pain is worse when abdo palpated through flexed abs. Negative = pain is better.
I think,

https://www.mindtools.com/pages/article/smart-goals.htm

mysleepwell.ca

Sink into sleep
Nerve blocks: ilioinguinal/iliohypogastric (these are blocked as a pair due to their close proximity to each other in the plane between the internal oblique and transversus abdominis muscles, and genitofemoral nerve

Previous
Previous
June 16

Culminating Session

Next
Next
June 30

Pain in the Elderly, Not What it Seems: Part 2