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. Significance Older age is an independent risk factor for long‐term analgesic use after surgery under neuraxial anaesthesiaanesthesia, indicating an increased risk for chronic postsurgical pain.