Deficiencias del tratamiento del dolor postoperatorio. Particularidades en el anciano: special features in the elderly

introduction: the postoperative pain is a health problem with a high incidence. the rate of the morbidity and mortality and the satisfaction of patients increase the hospital charges. objective: to review the deficiencies of pain treatment and to update the approach in elderly according to guidelines of evidence-based clinical practices. development: some deficiencies in its treatment produce the unnecessary suffering and its course to chronic state. the solution of this problem depends on the efficient organization of health staff. the patients aged over 65 are a group of high risk to receive an inappropriate treatment. the behavior in the face of the postoperative pain is similar to that of the rest of population. in those cases with cognitive deficit are necessary non verbal markers for monitoring. there is a benefit with regional techniques for the postoperative analgesia and with non-pharmacological methods. the dose of analgesic must to be decreased at least in the 50% of this age group and some opioids are contraindicated mainly the meperidine due to the risk of postoperative delirium. conclusions: an efficient and individualized treatment of postoperative pain guarantees the quality of the postoperative recovery and the assisting one.