ANALGESIA AND SEDATION IN THE ELDERLY

As a rule, a reduction in the usual adult dose of drugs acting on the central nervous system is to be recommended. The rationale behind this are the changes in both pharmacodynamics and pharmacokinetics that accur with increasing age. In the area of intensive care and, to a particular degree, during sepsis, the dynamics and kinetics of all medicinal drugs employed can show considerable interindividual variations. In such a situation, it is no longer possible to make generally applicable statements about age-related pharmacological effects. In principle, however, the same substances are suitable for analgesia in the older patient as are used in the younger patient. At present, benzodiazepines, with their wide therapeutic spectrum, given in combination with opioids, represent the most reliable and safest form of analgosedation. In particular in the aged, however, long-action benzodiazepines should not be administered.