title: Influences of the aging process on acute perioperative pain management in elderly and cognitively impaired patients.
abstract: BACKGROUND
  The aging process results in physiological deterioration and compromise along with a reduction in the reserve capacity of the human body. Because of the reduced reserves of mammalian organ systems, perioperative stressors may result in compromise of physiologic function or clinical evidence of organ insult secondary to surgery and anesthesia. The purpose of this review is to present evidence-based indications and best practice techniques for perioperative pain management in elderly surgical patients.
  
  
  RESULTS
  In addition to pain, cognitive dysfunction in elderly surgical patients is a common occurrence that can often be attenuated with appropriate drug therapy. Modalities for pain management must be synthesized with intraoperative anesthesia and the type of surgical intervention and not simply considered a separate entity.
  
  
  CONCLUSIONS
  Pain in elderly surgical patients continues to challenge physicians and healthcare providers. Current studies show improved surgical outcomes for geriatric patients who receive multimodal therapy for pain control.
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, New Haven, CT.
authors.forename: Thomas
authors.initials: T
authors.lastname: Halaszynski
keywords: Aging; pain management; perioperative care