I’ve been noticing an increase in elderly patients undergoing anesthesia, and their reactions to opioids can be quite unpredictable. Given the renal and hepatic considerations in this demographic, how are you managing dosage adjustments for opioids like fentanyl or hydromorphone during surgery? I’m particularly interested in the strategies you’re using to balance pain management with the risk of respiratory depression.
I’ve found that starting with lower doses of fentanyl typically helps avoid the unpredictable reactions in elderly patients. ‘Balancing pain management’ is crucial, so I often rely on multi-modal pain strategies alongside opioids to decrease overall dosage. Have you tried integrating regional techniques or non-opioid analgesics in your practice?
I’ve found that frequent reassessment of pain levels after initial dosing really helps adjust as needed. Sometimes, even the ‘normal’ opioid doses can hit differently with the elderly. Have you tried using multimodal strategies in conjunction with opioids yet, @kpatel2023?