The influence of advanced age on long-term postsurgical analgesic use in patients receiving neuraxial anaesthesia for elective surgery

Objective: To determine the relationship between age and long-term postsurgical analgesic use in patients who underwent elective surgery with neuraxial anaesthesia.Design: Retrospective observational study using data from the National Health Insurance Research Database of Taiwan from 2015 to 2019.Setting: National Health Insurance Research Database of Taiwan.Patients:A total of 12,810 patients (6405 younger and 6405 older) matched using propensity score matching.Interventions: Older (>= 65 years).Measurements:The use of long-term (3 or 6 months) postoperative analgesics, including opioids, as a surrogate marker of chronic postsurgical pain (CPSP) was analysed using logistic regression.Main Results:After 3 months of surgery, older adults had higher use of all analgesics (odds ratio [OR] = 1.15; 95% CI = 1.03-1.28) and opioids (OR = 1.18; 95% CI = 1.09-1.28) compared to younger patients. Similar results were observed after 6 months of surgery (all analgesic use: OR = 1.11; 95% CI = 1.03-1.20; opioid use: OR = 1.33; 95% CI = 1.07-1.81).Conclusion: The findings from this study suggest that older adults are more likely to experience CPSP and have increased use of long-term analgesics, including opioids, after undergoing elective surgery with neuraxial anaesthesia. The study highlights the need for improved pain management strategies for older adults after surgery.