Review Article
Postoperative Pain Management for Geriatrics – A Brief Review Focused on Administering Drugs and Providing Nerve Block
Volume 28,Issue 2,Pages 15-22
Jing-Yan Guo1 , Chin-Yi Yeh1 , Ying-Zeng Chen1

1Department of Anesthesiology, Tainan Hospital, Ministry of Health and Welfare, 125 Zhongshan Rd., Tainan City 70043, Taiwan

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Outline

Abstract

An aging population is a crucial issue faced by many countries. The number of people over 65 years old was estimated to be 5.06 million in 2008 and will increase to 130 million by 2040 worldwide. Pain during the treatment of the elderly is very common in surgical and non-surgical conditions. It can develop into chronic pain, delay functional recovery, prolong medical care, and increase life burden. Therefore, it is worthwhile to notice pain problems in the elderly that are often unrecognized and poorly controlled. To solve this problem, it is recommended to predict postoperative morbidity using a comprehensive geriatric assessment in the preoperative period. The Face Pain Scale has been verified for the evaluation of pain assessment, especially for older adults with cognitive impairment. Elderly patients usually have complex medical conditions that require polypharmacy that includes opioid/no-opioid drugs. According to the US Drug Pain Management Guidelines, opioids should be the first consideration. They should be combined with non-opioid adjuvants for moderate to severe postoperative pain. It is also reasonable to use multimodal analgesia in geriatric populations for postoperative pain control, especially neurological blockade to relieve severe pain. For geriatric populations, these treatments decrease pain and improve overall quality of care.

Key Words

geriatric medicine, geriatric pain, postoperation pain, opioid, nerve block



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