ArticleClinical drug investigation2019
Opioid Use and Pain Control in the Elderly After Elective or Urgent Orthopaedic Surgery: A Retrospective Cohort Study.
Article in Clinical drug investigation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Pooled it
- Incidence and Risk Factors for Postoperative Delirium in Patients Undergoing Spine Surgery: A Systematic Review and Meta-Analysis.BioMed research international · 2019Pooled it
- Intrathecal Morphine vs Paravertebral Nerve Blocks for Analgesia After Breast Reconstruction With Abdominally Based Free Flaps.Aesthetic surgery journal · 2025Article
- Transdermal Fentanyl Patch Effectiveness in Postoperative PainManagement in Orthopedic Patients: Literature Review.Journal of clinical medicine · 2024Review
- Nonopioid analgesic use in older patients admitted for orthopedic rehabilitation.PM & R : the journal of injury, function, and rehabilitation · 2024Article
- Risk Factors for Acute Postsurgical Pain: A Narrative Review.Journal of pain research · 2024Review
- Opioid use in older orthopedic rehabilitation inpatients: a retrospective study.European journal of physical and rehabilitation medicine · 2023Observational
- Chronic Pain after Bone Fracture: Current Insights into Molecular Mechanisms and Therapeutic Strategies.Brain sciences · 2022Review
- The Impact of Perioperative Multimodal Pain Management on Postoperative Outcomes in Patients (Aged 75 and Older) Undergoing Short-Segment Lumbar Fusion Surgery.Pain research & management · 2022Article
- Prescription Opioid Misuse in Older Adult Surgical Patients: Epidemiology, Prevention, and Clinical Implications.Journal of addictions nursingReview
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs an increasing number of elderly are undergoing orthopaedic procedures, it is important to understand and evaluate postoperative pain management in this population, especially in regard to opioid use. Data in the literature pertaining to the very elderly remains scarce.
objectivesThis study was conducted to evaluate whether older patients require lower opioid doses than their younger counterparts after undergoing an elective or urgent orthopaedic procedure, and to assess the cumulative incidence of adverse events and length of stay for each age group.
methodsA retrospective cohort study was performed to compare the mean opioid use and pain control between two groups of elderly patients (65-79 years and ≥ 80 years of age). The study included 250 patients who underwent either an elective arthroplasty or urgent orthopaedic surgery following a fracture. Data were collected during the 7 days following surgery.
resultsNo significant difference was found in mean and maximal pain scores between the two groups. Opioid use (expressed in intravenous morphine equivalents) was higher in the younger group. The difference reached statistical significance on the first postoperative day (subjects 65-79 years of age taking 21.3 mg, vs. 10.9 mg for the group over 80 years of age; mean difference 10.3 mg, 95% confidence interval 1.3-19.4). This was also observed in patients undergoing elective surgery on postoperative days 1, 5, 6 and 7. No difference in opioid use was observed between age groups in patients undergoing urgent surgery. Acute cognitive status deterioration, delirium, oxygen desaturation and constipation were observed more frequently in the older group, while mean length of stay was higher in the older group undergoing urgent surgery (8 vs. 17 days, p < 0.001).
conclusionsOur findings further support age-related differences in opioid requirements during the postoperative context after elective orthopaedic surgery, while no difference was found between age groups after urgent surgery.
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