title: 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.
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.
authors: 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.
authors: Fabio
authors: F
authors: Guerriero
authors: Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, Pavia, Italy.
authors: Niccolo
authors: N
authors: Maurizi
authors: Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, Pavia, Italy.
authors: Matthew
authors: M
authors: Francis
authors: Department of Internal Medicine and Medical Therapy, Section of Geriatrics, University of Pavia, Pavia, Italy.
authors: Carmelo
authors: C
authors: Sgarlata
authors: 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.
authors: Giovanni
authors: G
authors: Ricevuti
authors: Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, Pavia, Italy ; Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Pavia, Italy.
authors: Mariangela
authors: M
authors: Rondanelli
authors: Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, Pavia, Italy ; Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Pavia, Italy.
authors: Simone
authors: S
authors: Perna
authors: Azienda di Servizi alla Persona, Istituto di Cura Santa Margherita of Pavia, Pavia, Italy.
authors: Marco
authors: M
authors: Rollone
mesh_terms: D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000209:etiology; D048909:Diabetes Complications; D004338:Drug Combinations; D005260:Female; D016330:Frail Elderly; D006801:Humans; D035002:Lower Extremity; D009270:Naloxone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use*; D059408:Pain Management; D011788:Quality of Life; D012883:Skin Ulcer / Q000150:complications
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; D009292:Narcotic Antagonists; D009270:Naloxone; D010098:Oxycodone
keywords: chronic pain; elderly; naloxone; opioids; oxycodone; skin ulcers