Pain Management Considerations in the Geriatric ED Patient: Start Low, Go Slow, But Get Somewhere

Safely treating pain in older adults can be a daunting undertaking. The authors sought clarity in available analgesic choices and dosing recommendations.

There is limited current research into this topic, there is a range of medications and dosing suggested in the literature. The 2023 American Geriatrics Society updated Beers Criteria represents the most up to date expert panel guidance on a wide variety of medications including analgesics. There is an opportunity in the literature to provide a more concrete framework for treating pain in older adults.

In this paper, medication choices, dosing ranges, and considerations available in the literature were reconciled into two tables. Moreover, an approach to thinking about and treating older adults as both a homogenous group but more importantly as a heterogenous group was undertaken. There are ample opportunities to further study how individual goals, functional status, frailty, old old age, comorbidities, and co-pharmacy impact analgesic choices for older adults.