Assessment and treatment of postoperative pain in older adults

Hospitals are experiencing an increase in surgical procedures aimed at improving function and quality of life for elders. However, recent reports of pain management practices of elder patients show that pain is underassessed and undertreated. High postoperative pain intensities have been associated with delayed ambulation, postoperative pulmonary complications, increased hospital length of stay, long-term functional impairment, and chronic pain syndromes in this age group. Aggressive pain control is needed, but challenges in assessing and treating pain in older adults make this difficult. The purpose of this article is to review strategies for assessing and treating postoperative pain in older adults. Attention is given to the challenges associated with mental and physical impairments experienced by elders and a review of assessment and pharmacologic and nonpharmacologic strategies are included.