# Chronic post-surgical pain in older adults: mechanisms, assessment, and management strategies

## TL;DR

Chronic post-surgical pain in older adults is influenced by multiple factors and requires personalized strategies for effective management.

## Contribution

The paper reviews mechanisms, assessment challenges, and management strategies for chronic post-surgical pain in older adults.

## Key findings

- Age-related changes in pain processing contribute to chronic post-surgical pain in older adults.
- Conventional analgesic therapies show limited effectiveness in managing chronic post-surgical pain.
- Multimodal and personalized strategies, such as regional anesthesia and acupuncture, show promise in reducing pain burden.

## Abstract

Chronic postsurgical pain (CPSP) in older adults is a multifactorial condition shaped by biological, psychological, and social determinants. This review synthesizes current evidence regarding the underlying mechanisms, clinical assessment, and management strategies for CPSP in the older adults. Key findings emphasize age related changes in pain processing, significant challenges in pain evaluation particularly among those with cognitive impairment, and the limited effectiveness of conventional analgesic therapies. Multimodal and personalized strategies, such as regional anesthesia, tailored pharmacologic interventions, and integrative approaches including acupuncture, demonstrate potential in reducing the incidence and burden of CPSP. Implementing structured assessment protocols and comprehensive geriatric care models is crucial for enhancing postoperative quality of life. Future initiatives should focus on integrating predictive tools, long term monitoring systems, and interdisciplinary collaboration to improve pain related outcomes in this vulnerable population.