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ORIGINAL RESEARCH article

Front. Anesthesiol.
Sec. Perioperative Medicine
Volume 3 - 2024 | doi: 10.3389/fanes.2024.1521994

Trajectories of pain after low opioid anesthesia and opioid-based anesthesia with non opioid postoperative analgesia in older adultsa perioperative clinical study

Provisionally accepted
Urszula Kościuczuk Urszula Kościuczuk *Katarzyna Tarnowska Katarzyna Tarnowska Ewa Rynkiewicz-Szczepanska Ewa Rynkiewicz-Szczepanska Agnieszka Kossakowska Agnieszka Kossakowska Marta Pryzmont Marta Pryzmont Agnieszka Gajo-Hermanowicz Agnieszka Gajo-Hermanowicz Marcin Talalaj Marcin Talalaj
  • Medical University of Bialystok, Bialystok, Poland

The final, formatted version of the article will be published soon.

    Background. Due to the significantly increasing size of the older and elderly population, more surgical and anesthesiological procedures are involved in the medical care of these group. Due to physiological changes during the aging process and comorbidities, perioperative safety and acute pain therapy with the dilemma of opioid use are crucial.We compared the analgesic trajectory of Low-Opioid Analgesia (LOA) and Opioid-Based Analgesia (OBA) within the first postoperative day in a group of patients over 60 years old. The hypothesis was that limiting the use of opioids in LOA would provide a comparable analgesic profile to OBA.Results. The trajectory of analgesia presented a negative slope in the LOA for patients over 60 years of age. There was a reduction in the pain intensity between the points of clinical evaluation of 1 NRS point, 0.5 NRS points, and 1 NRS point, representing 33%, 25%, and 66%, respectively, relative to the baseline. In the OBA, a positive slope trajectory was noted. The pain intensity remained higher between 12 -24 hours than in the immediate postoperative periods of 0-2 hours and 2-6 hours.Conclusions. The hypothesis of comparable analgesic quality of LOA and OBA in the group of patients over 60 years old should be rejected. Opioid analgesia presented a better effect in the immediate postoperative period (0-2h). Non-opioid analgesia is indicated in the later postoperative period. The model of combined minimal opioid anesthesia and non-opioid postoperative analgesia presents a favorable therapeutic effect for patients over 60 years old.

    Keywords: Analgesia, Elderly, opioid, Pain, Surgery

    Received: 03 Nov 2024; Accepted: 13 Dec 2024.

    Copyright: © 2024 Kościuczuk, Tarnowska, Rynkiewicz-Szczepanska, Kossakowska, Pryzmont, Gajo-Hermanowicz and Talalaj. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Urszula Kościuczuk, Medical University of Bialystok, Bialystok, Poland

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