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Pain Management

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Principles and Practice of Geriatric Surgery

Abstract

Whereas postoperative pain was once thought to be an inevitable, albeit severely unpleasant, consequence of surgery, it is now clear that appropriate analgesic therapies can result in effective pain management for nearly all surgical patients. Nevertheless, despite recent efforts to improve management of pain in the United States, undertreatment of pain, particularly postoperative pain, remains a persistent problem.1,2 This undertreatment appears to be dramatically worse in the elderly.3 Untreated or undertreated pain may have a substantial impact on patients’ postoperative recovery and may exacerbate underlying co-morbidities and normal age-related physiologic changes. Pain can induce tachycardia, increase myocardial oxygen requirements, and produce cardiac ischemia. Pain, or the fear of pain, may lead to limited postoperative physical activity, which may further increase the risk of thromboembolism, urinary retention, fecal impaction, ileus, and atelectasis. For all these reasons, control of postoperative pain in the elderly surgical patient is of critical importance.

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Authors
  1. R. Sean Morrison
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  2. Maria Torroella Carney
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  3. Paolo L. Manfredi
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Editor information

Editors and Affiliations

  1. Department of Surgery, Yale University School of Medicine, New Haven, CT, 06520, USA

    Ronnie A. Rosenthal MD (Associate Professor, Chief, Surgical Service) (Associate Professor, Chief, Surgical Service)

  2. Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, 06516, CT, USA

    Ronnie A. Rosenthal MD (Associate Professor, Chief, Surgical Service) (Associate Professor, Chief, Surgical Service)

  3. Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, 10461, NY, USA

    Michael E. Zenilman MD (Associate Professor and Vice-Chairman, Chief of Surgery) (Associate Professor and Vice-Chairman, Chief of Surgery)

  4. Jack D. Weiler Hospital of the Albert Einstein College of Medicine, Bronx, 10461, NY, USA

    Michael E. Zenilman MD (Associate Professor and Vice-Chairman, Chief of Surgery) (Associate Professor and Vice-Chairman, Chief of Surgery)

  5. Wyoming Valley Surgical Associates, Kingston, 18704, PA, USA

    Mark R. Katlic M.D. (Chief of Thoracic Surgery) (Chief of Thoracic Surgery)

  6. Wyoming Valley Healthcare System, Wilkes-Barre, 18702, PA, USA

    Mark R. Katlic M.D. (Chief of Thoracic Surgery) (Chief of Thoracic Surgery)

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Morrison, R.S., Carney, M.T., Manfredi, P.L. (2001). Pain Management. In: Rosenthal, R.A., Zenilman, M.E., Katlic, M.R. (eds) Principles and Practice of Geriatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3432-4_12

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  • DOI: https://doi.org/10.1007/978-1-4757-3432-4_12

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