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Master Thesis

L'analgésie péri-opératoire en chirurgie viscérale et orthopédique chez les patients âgés de 75 ans et plus

Abstract : Introduction: no studies have been conducted to determine the frequency of postoperative use of nefopam and tramadol in elderly, while they are iatrogenic. Objectives: describe perioperative analgesia used in the elderly in visceral and orthopedic surgery and its effectiveness. To identify independent prescribing factors for nefopam and tramadol, to describe the incidence of post-operative delirium, and to identify predictive factors, including drug confounding factors. Method: we conducted a multicenter prospective observational study from July to November 2019. The study was carried out in the orthopedic and visceral surgical departments at Bordeaux University Hospital and 4 others centers. Results: 170 patients were included, 135 patients aged 75 years and more (median age 85) and 35 patients aged 65-74 years (median age 69). Nefopam and/or tramadol was prescribed in 73% of those over 75 versus 89% of those aged 65-74, p = 0, 049. The average pain of those over 75 years was 3.8/10 according to the NRS compared to 3.2/10 for those 65 to 74 years (p=0,25). We did not find any factors significantly associated with the prescription of tramadol and nefopam. Tramadol and nefopam was not associated with the onset of delirium. Moderate to severe pain was an independent risk factor for confusion (p=0,04). Conclusion: our study confirms the overconsumption of tramadol and nefopam in peri-operative in the elderly. Pain control is sub-optimal and multi-professional work would allow the development of an analgesic protocol adapted to this frail population.
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https://dumas.ccsd.cnrs.fr/dumas-03008263
Contributor : Médecine Ub <>
Submitted on : Monday, November 16, 2020 - 4:58:52 PM
Last modification on : Saturday, December 19, 2020 - 3:12:50 AM
Long-term archiving on: : Wednesday, February 17, 2021 - 7:45:50 PM

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Julie Guiffant. L'analgésie péri-opératoire en chirurgie viscérale et orthopédique chez les patients âgés de 75 ans et plus. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03008263⟩

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