MANAGEMENT OF POSTOPERATIVE PAIN IN THE E LDERLY

Postoperative pain is an acute pain that is virtually always present b ut varies in intensity, Its duration is generally 48 h, Postoperative pain has harmful effects, and the notion that pain is a useful beacon that alerts to possible complications has been laid to rest. Confusion or delusions may occur in elderly patients, masking the presence of p ain. Pain severity can be self-assessed using a visual analog scale by patients with intact cognitive functions. No satisfactory instrument for pain severity assessment by another person is available for use in patients with cognitive impairment. Pain titration by injection of in creasing doses of an analgesic is the best means for determining pain seventy in all patients, Lower doses at. more widely spaced intervals should be used to correct for age-related increases in the free fracti on and half-life of analgesics. Narcotic-acetaminophen combinations ar e widely used, whereas controversy surrounds the administration of loc al anesthetics during and after the surgical procedure as local inject ions, plexus blocks, or epidural injections. A study reported herein s upports patient-controlled analgesia via a programmable pump.