Healthcare. Postoperative Pain: Children, Adults, Elderly (Part 2)

Postoperative pain remains one of the most common problems in modern surgery and postoperative patient management. According to international studies, pain after surgery occurs in most patients and can lead to complications, prolongation of the rehabilitation period and the formation of chronic pain syndrome. The specifics of the occurrence, assessment and treatment of postoperative pain differ significantly depending on the age of patients, in children, adults and the elderly. Purpose of the work. To analyze current scientific data on the prevalence, mechanisms of development, assessment, and treatment of postoperative pain in children, adults, and elderly patients to substantiate differentiated approaches to multimodal analgesia. A systematic review of scientific publications for 2001–2025 devoted to the problem of postoperative pain in different age groups of patients was conducted. The literature was searched in the scientometric databases PubMed, PMC, Google Scholar and Scopus by keywords postoperative pain, multimodal analgesia, pediatric pain, elderly postoperative pain, central sensitization. The methodological basis of the study was the principles of evidence-based medicine and international guidelines for the management of postoperative pain, in particular PRISMA 2020, PROSPECT, ERAS, as well as the evidence quality assessment tools RoB 2, ROBINS-I and GRADE. It has been established that the frequency of postoperative pain is on average 70-85% among patients after surgical interventions. In children, postoperative pain is often underestimated due to communication difficulties and age-related behavior, which requires the use of special assessment tools and a combination of pharmacological and non-pharmacological methods of pain relief. In adult patients, pain is characterized by a combination of somatic and visceral components and can contribute to the development of central sensitization and chronic pain syndrome. In elderly patients, postoperative pain often has a lower intensity, but a longer course and is accompanied by an increased risk of complications due to comorbidity, polypharmacy and age-related changes in the pharmacokinetics and pharmacodynamics of drugs. It has been shown that the most effective strategy is multimodal analgesia, which combines non-steroidal anti-inflammatory drugs, paracetamol, regional anesthesia methods, adjuvant drugs, and non-drug treatments. Postoperative pain is a multifactorial problem that requires an individualized approach to assessment and treatment depending on the age of the patient. The use of multimodal analgesia strategies, standardized pain assessment tools and interdisciplinary interaction of medical professionals contributes to improving the control of postoperative pain, reducing the risk of its chronicity, and increasing the effectiveness of postoperative rehabilitation.