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Schmerzen

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Neurogeriatrie

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Zusammenfassung

Neurogeriatrische Patienten mit Schmerz als Komorbidität werden häufig nur unzureichend behandelt. Eine gezielte Schmerzdiagnostik und -therapie wird besonders anspruchsvoll, wenn kognitive Fähigkeiten eingeschränkt sind. Im diagnostischen schmerzmedizinischen Fokus steht eine strukturierte Anamnese, welche gemäß ICF-Modell zusätzlich zu Organ-bezogenen Fragen Funktionalität und psychosoziale Faktoren berücksichtigt. Eine Strukturierung der Schmerzanamnese und -diagnostik kann Behandlern helfen, einen ganzheitlichen Eindruck ihrer Patienten zu gewinnen. Für die medikamentöse Schmerztherapie sind einige Präparate besser geeignet (z. B. Paracetamol), andere in Leitlinien empfohlene Schmerzmedikamente (z. B. Amitriptylin) sind aufgrund ihrer anticholinergen Begleitwirkung nur eingeschränkt bis gar nicht einsetzbar. Der Schmerztherapeut erhält Hilfestellung in der PRISCUS- und der FORTA-Liste. Im FORTA-Konzept wird zudem eine Graduierung von „hoher Nutzen“ bis „hohes Risiko“ vorgenommen.

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Authors and Affiliations

  1. Klinik für Neurologie UKSH, Campus Kiel, Kiel, Deutschland

    Philipp Hüllemann & Ralf Baron

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  1. Philipp Hüllemann
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  2. Ralf Baron
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Correspondence to Ralf Baron .

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Editors and Affiliations

  1. Klinik für Neurologie, UKSH, Campus Kiel, Kiel, Germany

    Walter Maetzler

  2. Lehrstuhl für Geriatrie, Universitätsklinikum Essen, Geriatriezentrum Haus Berge, Contilia Group, Essen, Germany

    Richard Dodel

  3. Klinik für Geriatrie mit Neurologie, Johanniter Krankenhaus Bonn, Bonn, Germany

    Andreas H. Jacobs

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Hüllemann, P., Baron, R. (2019). Schmerzen. In: Maetzler, W., Dodel, R., Jacobs, A. (eds) Neurogeriatrie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57358-7_16

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  • DOI: https://doi.org/10.1007/978-3-662-57358-7_16

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