5 doctors weighed in:

Can pain make delirium worse?

5 doctors weighed in
Dr. Lynne Weixel
Clinical Psychology
3 doctors agree

In brief: Absolutely!

Very ill or aged folk can have delirium triggered by minor additional symptoms and pain is a common one.
Management can be difficult w/out extreme sedation and that can risk or hasten death. But it can pass - it is a mental state - not a disease in itself. Try to keep the situation as calm and peaceful as possible. Try to recall the good times and stories of such a long life - that might help.

In brief: Absolutely!

Very ill or aged folk can have delirium triggered by minor additional symptoms and pain is a common one.
Management can be difficult w/out extreme sedation and that can risk or hasten death. But it can pass - it is a mental state - not a disease in itself. Try to keep the situation as calm and peaceful as possible. Try to recall the good times and stories of such a long life - that might help.
Dr. Lynne Weixel
Dr. Lynne Weixel
Thank
Dr. Maureen Nash
Psychiatry - Geriatric

In brief: Yes

pain causes significant stress on cognitive reserve and the central nervous system.
It is a well established cause of delirium. One of the challenges is that pain medicines like opiates can also cause delirium. There is a careful clinical balance that can be difficult to attain. Good communication between the patient, family and medical team is important.

In brief: Yes

pain causes significant stress on cognitive reserve and the central nervous system.
It is a well established cause of delirium. One of the challenges is that pain medicines like opiates can also cause delirium. There is a careful clinical balance that can be difficult to attain. Good communication between the patient, family and medical team is important.
Dr. Maureen Nash
Dr. Maureen Nash
Thank
Dr. Jeff Seaman
Psychiatry

In brief: Likely, but

Details are unclear. Indirect evidence and clinically sepaking, yes it can.
I suspect the secondary effects of pain on sleep impairment and increased opioid use may contribute. Opioids are not strictly contraindicated however. At times, they may simply need to be rotated. Unclear if inflammatory cytokines precipitate or sustain delirium (acute brain failure).

In brief: Likely, but

Details are unclear. Indirect evidence and clinically sepaking, yes it can.
I suspect the secondary effects of pain on sleep impairment and increased opioid use may contribute. Opioids are not strictly contraindicated however. At times, they may simply need to be rotated. Unclear if inflammatory cytokines precipitate or sustain delirium (acute brain failure).
Dr. Jeff Seaman
Dr. Jeff Seaman
Thank
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