{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:25:36Z","timestamp":1791066336291,"version":"4.1.0"},"reference-count":72,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The administration of analgesic drugs in elderly patients should take into account age-related physiological changes, loss of efficiency of homeostatic mechanisms, and pharmacological interactions with chronic therapies. Underestimation of pain in patients with impaired cognition is often linked to difficulties in pain assessment. In the preoperative phase, it is essential to assess the physical status, cognitive reserve, and previous chronic pain conditions to plan effective analgesia. Furthermore, an accurate pharmacological history of the patient must be collected to establish any possible interaction with the whole perioperative analgesic plan. The use of analgesic drugs with different mechanisms of action for pain relief in the intraoperative phase is a crucial step to achieve adequate postoperative pain control in older adults. The combined multimodal and opioid-sparing strategy is strongly recommended to reduce side effects. The use of various adjuvants is also preferable. Moreover, the implementation of non-pharmacological approaches may lead to faster recovery. High-quality postoperative analgesia in older patients can be achieved only with a collaborative interdisciplinary team. The aim of this review is to highlight the perioperative pain management strategies in the elderly with a special focus on intraoperative pharmacological interventions.<\/jats:p>","DOI":"10.4103\/sja.sja_643_23","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T03:50:18Z","timestamp":1692244218000},"page":"491-499","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Perioperative analgesia in the elderly"],"prefix":"10.4103","volume":"17","author":[{"given":"Filippo","family":"Del Tedesco","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze dell\u2019emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaminio","family":"Sessa","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikardo","family":"Xhemalaj","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Sollazzi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy"},{"name":"Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Dello Russo","sequence":"additional","affiliation":[{"name":"Dipartimento di Sicurezza e Bioetica, Sezione di Farmacologia, Universit\u00e0 Cattolica Del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"},{"name":"Department of Pharmacology and Therapeutics, Institute of Systems Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Aceto","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell\u2019emergenza, anestesiologiche e della rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. 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