UMEM Educational Pearls

Category: Orthopedics

Title: Pain Control in the Elderly

Keywords: Pain, Geriatrics (PubMed Search)

Posted: 9/18/2010 by Michael Bond, MD (Updated: 6/15/2024)
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Pain Control in the Elderly

  • Narcotic pain relievers are often avoided in the elderly due to the concern of sedation, risk of falls and the concern of them causing delirium.
  • Delirium can cause significant morbidity and mortality and can be difficult to differentiate between the sedation and mild confusion that often occurs with opioid dose escalation.
  • However, delirium has been shown to occur more commonly as a result of the under treatment of pain rather than as an opioid adverse effect.

So the take home lesson for this pearl is that the elderly have a lower risk of delirium if their pain is treated appropriately.


Duggleby W, Lander J: Cognitive status and postoperative pain: older adults. J Pain Symptom Manage 1994; 9: 19-27.

Lynch EP, Lazor MA, Gellis JE, Orav J, Goldman L, Marcantonio ER: The impact of postoperative pain on the development of postoperative delirium. Anesth Analg 1998; 86: 781-785.