Age Matters Even When the Protocol Doesn't: Opioid Administration Decreases Across the Surgical ICU Age Spectrum

Older adults are at increased risk of adverse effects from opioids. This retrospective review, conducted at an adult level I trauma center, explores age-related differences in opioid administration among surgical intensive care unit (SICU) patients using a multimodal pain protocol that does not account for age. Daily opioid use was quantified in morphine milligram equivalents (MMEs), and the average morphine equivalent daily dose (MEDD) was determined across 3 age groups in ventilated and non-ventilated patients. Multivariate log-transformed linear regression analysis evaluated the association between age group and average MEDD, while controlling for sex and race. Patients older than 64 years had a lower average MEDD than younger patients in both ventilation cohorts, with a significant decrease in average MEDD compared to those 45 years or younger. These findings emphasize the need to account for age when developing pain and sedation management strategies in an aging United States population.