Postoperative Pain Management in the Frail Elderly

Preventing Postoperative Complications in the Elderly

“…Higher pain scores at rest during the first three postoperative days are associated with postoperative delirium in patients undergoing non-cardiac surgery28. Increased levels of both preoperative and postoperative pain are risk factors for development of postoperative delirium 29.…”

Management of Postoperative Analgesia in Elderly Patients

“…104 In the same way, meperidine is not appropriate in the elderly because of the accumulation of its renally excreted active (and deleterious) metabolite, normeperidine, resulting in central nervous system excitation, tremors, and seizures. Methadone must be used with caution because of its long half-life and a risk of accumulation in elderly patients.…”

Pain and nutrition as experienced by patients with hip fracture

“…These patients often suffer from concurrent medical and psychiatric disorders, so that their rehabilitation is a challenging task ( Strömberg, 1998). There is a consensus today concerning the treatment of hip fracture patients: early operation, adequate anaesthesia, early mobilization, rapid return to the prefracture residence ( Zuckerman et al ., 1992 ; Thorngren, 1996), sufficient pain relief ( Herr & Mobily, 1991; Closs et al ., 1993 ; Egbert, 1996) and good nutritional status, including only short periods of fasting ( Patterson et al ., 1992 ; Tkatch et al ., 1992 ; Porter & Johnson, 1998). However, few existing programmes include both medical and nursing interventions.…”