Perioperative analgesia in the elderly.

Del Tedesco, Filippo, Sessa, Flaminio, Xhemalaj, Rikardo, Sollazzi, Liliana, Dello Russo, Cinzia ORCID: 0000-0002-2538-3832 and Aceto, Paola (2023) Perioperative analgesia in the elderly. Saudi journal of anaesthesia, 17 (4). pp. 491-499.

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Abstract

The administration of analgesic drugs in elderly patients should take into account age-related physiological changes, loss of efficiency of homeostatic mechanisms, and pharmacological interactions with chronic therapies. Underestimation of pain in patients with impaired cognition is often linked to difficulties in pain assessment. In the preoperative phase, it is essential to assess the physical status, cognitive reserve, and previous chronic pain conditions to plan effective analgesia. Furthermore, an accurate pharmacological history of the patient must be collected to establish any possible interaction with the whole perioperative analgesic plan. The use of analgesic drugs with different mechanisms of action for pain relief in the intraoperative phase is a crucial step to achieve adequate postoperative pain control in older adults. The combined multimodal and opioid-sparing strategy is strongly recommended to reduce side effects. The use of various adjuvants is also preferable. Moreover, the implementation of non-pharmacological approaches may lead to faster recovery. High-quality postoperative analgesia in older patients can be achieved only with a collaborative interdisciplinary team. The aim of this review is to highlight the perioperative pain management strategies in the elderly with a special focus on intraoperative pharmacological interventions.

Item Type:	Article
Uncontrolled Keywords:	Analgesia, elderly patients, multimodal analgesia, opioid-sparing
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	12 Dec 2023 08:51
Last Modified:	12 Dec 2023 09:27
DOI:	10.4103/sja.sja_643_23
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3177257