Aches and Pain in the Geriatric Trauma Patient

• Published in: Current trauma reports Vol. 6; no. 4; pp. 174 - 182
• Main Authors: Brown, Laura R., Ferre, Alexandra C., Ho, Vanessa P.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-12-2020
• Subjects: Critical Care Medicine; Emergency Medicine; Intensive; Medicine; Medicine & Public Health; Pain Management in Trauma (MR Hoffman; Rehabilitation; Section Editor; Surgery; Topical Collection on Pain Management in Trauma; Traumatic Surgery; Pain management/methods; Pain measurement in older adults; Pain; Analgesics; Opioid/adverse effects/therapeutic use; Postoperative/drug therapy; Geriatrics/methods; Multimodal analgesia
• ISSN: 2198-6096; 2198-6096
• DOI: 10.1007/s40719-020-00202-w

Purpose of Review
This review examines the pain control options for geriatric trauma patients, who represent an increasing proportion of the trauma population.
Recent Findings
Current pain management of geriatric trauma patients has evolved to a multimodal pain approach including non-opioid medications and regional anesthesia, due to safety concerns with respiratory depression and delirium when using primarily opioid-based pain regimens. Ideal regimens incorporate treatment of multiple pain pathways to decrease the required dosages of all pain medicine to safer thresholds, especially in the geriatric patient population. Intravenous, oral, and transdermal adjunctive medications provide effective pain control for these patients. Regional anesthesia also improves pain control and decreases narcotic use, especially in the setting of rib and femoral fractures.
Summary
The growing population of elderly trauma patients requires thoughtful multimodal pain therapy regimens tailored to injury type and personalized to the patient’s comorbidities to optimize outcomes and prevent complications.