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TL;DR
The central recommendation is that combined multimodal and opioid-sparing analgesia is essential to optimize pain control while minimizing age-related adverse effects in older adults.
Saudi Journal of Anaesthesia · 6 authors, 4 centres
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The central recommendation is that combined multimodal and opioid-sparing analgesia is essential to optimize pain control while minimizing age-related adverse effects in older adults.
Age-related physiological changes, comorbidities, and polypharmacy complicate analgesia in older adults, necessitating individualized preoperative assessment of physical status, cognitive reserve, and chronic pain conditions. Adjuvants including dexamethasone, magnesium sulfate, and ketamine at sub-anesthetic doses are discussed as means to reduce opioid requirements. Target-controlled infusion of remifentanil compared to conventional infusion reduces peri-incisional hyperalgesia. The review concludes that a collaborative interdisciplinary team approach combining multimodal analgesia with non-pharmacological methods is essential for optimizing outcomes in this vulnerable population.