Deborah Dillon McDonald, RN, PhD, Associate Professor, University of Connecticut School of Nursing, Storrs, CT.

Older adults experience moderate to severe postoperative pain during and after their hospital stay. Preoperative education about pain management decreases postoperative pain. Postoperative pain management should generally include concurrent treatment of pre-existing chronic pain problems and a multimodal approach that incorporates postoperative opioids, nonopioids, and nonpharmacologic pain treatments. Opioids should be started at 25-50% of the adult dose and titrated until pain is reduced to a mild level. Older adults should be monitored closely to prevent side effects from opioid accumulation. A consistent pain scale that the older adult understands should be used to evaluate the pain response.
Key words: postoperative pain, pain assessment, opioids, nonopioids, nonpharmacologic treatments.