Mercadante Sebastiano
Main Regional Center for Pain Relief and Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, 90146, Italy.
J Anesth Analg Crit Care. 2024 Aug 1;4(1):51. doi: 10.1186/s44158-024-00182-2.
The older population continues to grow in all countries, and surgeons are encountering older patients more frequently. The management of postoperative pain in older patients can be a difficult task. Opioids are the mainstay of perioperative pain control. This paper assesses some pharmacokinetic age-related aspects and their relationship with the use of opioids in the perioperative period. Changes in body composition and organ function, and pharmacokinetics in older patients, as well as characteristics of opioids commonly used in the perioperative period are described. Specific problems, dose titration, and patient-controlled analgesia in the elderly are also reviewed. Opioids can be safety used in perioperative period, even in the elderly. The choice of drugs and doses can be individualized according to the surgery, opioid pharmacokinetics, comorbidities, and routes of administration.
所有国家的老年人口都在持续增长，外科医生越来越频繁地遇到老年患者。老年患者术后疼痛的管理可能是一项艰巨的任务。阿片类药物是围手术期疼痛控制的主要手段。本文评估了一些与年龄相关的药代动力学方面及其与围手术期阿片类药物使用的关系。描述了老年患者身体成分和器官功能的变化、药代动力学，以及围手术期常用阿片类药物的特点。还回顾了老年人的特殊问题、剂量滴定和患者自控镇痛。阿片类药物在围手术期甚至在老年人中都可以安全使用。药物和剂量的选择可以根据手术、阿片类药物药代动力学、合并症和给药途径进行个体化。
