Principles of perioperative pain management in older adults.
The consequences of poor planning for pain management during surgery of geriatric patients not only affect the immediate well-being of the patient but also have terrible socioeconomic implications. Delays in rehabilitation, increases in hospital lengths of stay, and increased comorbidity can be expected if interventions for pain management are either inadequate or excessive without appropriate monitoring. During surgery, seniors are likely to suffer from acute and chronic pain that must be addressed aggressively in the postoperative period to ensure a rapid functional recovery. New pain scales have been developed with seniors in mind, and greater testing of older scales in elderly populations have helped to identify measures of pain more suited to frail seniors. This article is designed to help clinicians to strategically implement optimal pain management principles and techniques and, thus, help to fulfill the obligation to relieve pain and suffering in patients in the perioperative period, which will ensure the greatest chance of recovery to optimal independence for patients.
Gloth
F M
FM
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. michaelg@helix.org
D000368:Aged; D015577:Geriatric Assessment; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D019990:Perioperative Care / Q000592:standards*