Manejo del dolor posquirúrgico en pacientes geriátricos. Revisión del alcance

Abstract

Abstract:The aging population is a challenge in the management of postsurgical pain. This age group presents physiological and pharmacological alterations that complicate analgesia. Post-surgical pain management continues to be a cause of functional impairment and increased suffering. Objective: To evaluate in the literature the efficacy of different pharmacological and non-pharmacological strategies for postoperative pain management in this population. A total of 67 articles were analyzed with a total of 7539 patients who underwent different surgeries. Psoas compartment block eliminated opioid consumption in the immediate postoperative period (p < 0.05), pericapsular nerve block minimized dynamic pain from 5.5 to 2.5 on the NRS scale. Periarticular infiltration decreased pain (VAS: 6.1 to 2.5), repeated dose dexamethasone demonstrated NRS of 2 at 16 hours. Transcutaneous electrical stimulation reduced pain an additional 30%, mindfulness was effective (p = 0.007), and use of a mobile app reduced the incidence of poorly controlled pain by 55%. These findings highlight the importance of personalized multidimensional approaches to optimize analgesia in geriatric patients.