Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications\r\ninvolving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients\r\nundergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia\r\nand analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of\r\npostop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse\r\nevents. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses\r\nand dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched\r\nfor relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements\r\nwere also utilized.The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative\r\nregional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part ofmultimodal\r\nperioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional\r\nanesthesia/analgesia has not been proven to improve long-termmorbidity but does benefit immediate postoperative pain control. In\r\naddition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse\r\neffects from opioids while maximizing analgesic effect and benefit.
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