Pain assessment and management for a dialysis patient with diabetic peripheral neuropathy.
More than 50% of all patients with end stage renal disease (ESRD) have pain, and this pain is often due to diabetic peripheral neuropathy. Using a case study of a dialysis patient who has neuropathic pain, this article examines the assessment and management of this pain. Assessment is the essential first step. Patients' self-report of pain is the most reliable and valid indicator of pain intensity. Pain may be managed through the use of non-opioids, opioids and adjuvants. However, for patients with ESRD on dialysis, certain considerations concerning drugs used to manage pain need to be taken into account. Complementary therapies have also been used in pain management in patients with ESRD, and there is a need for greater research in this area.
Innis
Jennifer
J
Pain Service, St. Michael's Hospital, Toronto, Ontario. innisj@smh.toronto.on.ca
D015667:Acupuncture Analgesia; D000368:Aged; D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D000529:Complementary Therapies; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003929:Diabetic Neuropathies / Q000150:complications*; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D009730:Nursing Assessment / Q000379:methods; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing; D010353:Patient Education as Topic; D006435:Renal Dialysis / Q000451:nursing; D017592:Skin Care; D004561:Transcutaneous Electric Nerve Stimulation; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin