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Thoracic Surgery in the Elderly Patient 

Thoracic Surgery in the Elderly Patient
Chapter:
Thoracic Surgery in the Elderly Patient
Author(s):

Melanie Donnelly

, and Elizabeth Wilson

DOI:
10.1093/med/9780190856649.003.0013
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date: 20 September 2019

Pain management in elderly patients poses unique challenges due to altered physiology (such as chronic renal insufficiency) and altered pharmacodynamics that make them more sensitive. Elderly patients undergoing thoracic surgery generally benefit from analgesic techniques that reduce the use of opioids and rely more on regional and neuraxial analgesic techniques using local anesthetics. In this chapter we provide an overview of the challenges of managing acute pain in the aged, discuss the benefits of using multimodal non-opioid analgesics in preventing chronic post-thoracotomy pain, and review the different regional and neuraxial analgesic techniques (i.e. paravertebral blocks, epidural analgesia) that can positively affect outcomes in the elderly after thoracic surgery.

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