CLINICAL CHARACTERISTICS OF POSTOPERATIVE ANALGESIA IN ELDERLY AND OLD PATIENTS

Abstract

Nearly 13% of the elderly and old population experience psychosomatic pain that is not regarded as a response to irritants. Diagnosis and treatment of the postoperative pain in old and elderly patients may be complicated by chronic pain or somatic diseases. The aim of this work was to study clinical characteristics of the postoperative pain in old and elderly patients. Materials and methods. This study based on analysis of 99 cases of the perioperative period. Patients were divided into groups by age: the 1st group included individuals aged 18-59 years, the 2nd group included individuals over 60 years. The influence of age, type of anesthesia and postoperative analgesia on the character and severity of pain was determined by questioning and clinical comparison. The Visual Analogue Scale and the McGill questionnaire were used to assess the pain intensity. Results and their discussion: the elderly patients demonstrated higher scores of the affective component to surgical intervention; moreover, the direct relationship between the affective and evaluative components and the indirect correlation of the sensitive component of pain with age was found out. There have been established the significant direct links between postoperative pain and its components in elderly people with the level of pain before surgery, intrathecal anaesthesia, and vascular surgery. Conclusions: in the elderly, in contrast to the younger individuals, the level of postoperative pain is more pronounced. The initial level of pre-operative pain in these patients definitely influences the level of postoperative pain. Simultaneously, the postoperative pain in the elderly is due to the greater lability of all the components of pain, with the prevalence of affective and evaluative components. The persistence of pain in the postoperative period is typical for elderly people who underwent vascular interventions and intrathecal anaesthesia. In the context of the conventional tactics of postoperative pain relief in the elderly people, the strength and the characteristics of the pain are more significantly intense relatively to those in younger patients that require an improvement in the tactics of pain management.