How To Manage Surgical Pain In Elderly Patients

By Erwin Juda, DPM, R.Ph.

   Pain management in the elderly remains one of the most challenging issues for the podiatric surgeon. As life expectancy continues to advance, more geriatric patients will undergo surgery. While these patients may undergo these procedures to help facilitate independence and a better quality of life, one must carefully weigh the risks and benefits of surgical intervention in this patient population.    Regardless of the success of the given surgical procedure, one may still encounter significant tissue damage and the subsequent release of pain and inflammatory mediators.1 While the principles of pain management remain fundamentally consistent across all age groups, there are unique challenges when it comes to alleviating the pain of elderly surgical patients.    Indeed, there are a number of barriers and misconceptions that can contribute to the inadequate assessment and treatment of pain in seniors. Factors affecting pain control include cognitive impairment, altered communication and misunderstanding regarding the use and effects of analgesics, especially narcotics.    Also keep in mind that older adults may not report pain due to the fear of further tests, the addition of supplemental medications or feeling intimidated by the knowledge and authority of their doctor.2    With these points in mind, let us take a closer look at pharmacologic intervention for acute postoperative pain in the geriatric patient.

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