A Bibliometric Analysis of Published Literature in Postoperative Pain in Elderly Patients in Low- and Middle-Income Countries.

João Batista Santos Garcia,José Osvaldo Barbosa Neto,Érica Brandão De Moraes

doi:10.3390/jcm10112334

Abstract

Postoperative pain (POP) remains a major challenge for surgeons and anesthesiologists worldwide, especially in low- and middle-income countries. Elderly patients are at higher risk for undertreatment of pain. Despite that, there is a paucity of papers addressing POP among this population in developing countries. This study aimed to provide a bibliometric analysis of the literature concerning postoperative pain in elderly patients from low- and middle-income countries. It was performed an extensive search of papers on this subject through the Web of Science and Scopus database using a series of uniterms and, including publications from 2001 to 2021. Publication quality was assessed by using total citation frequency, average citations per item and other citation indexes. Citation indexes were low, with the highest reaching 15 citations. In conclusion, few studies of postoperative pain in the elderly in countries with medium and low income, indicating a need that has not yet been met for this population and in these areas of the world. The published studies were not specifically aimed at the elderly, had limited impact, low international visibility. They were not epidemiological studies and are not robust, weakening knowledge and decision-making towards policies directed at this vulnerable population.

Highlights

Postoperative pain (POP) remains a major challenge for surgeons and anesthesiologists worldwide, especially in low- and middle-income countries, due to important limitations, such as technological and human resources and availability of analgesics [1,2,3,4].POP incidence available in the literature usually reflects data from specific surgeries or reflects regional realities and, presents great variability, showing averages ranging from 14–62% [1,2,5,6]
The elderly population accumulates different aspects that lead to a greater risk of POP: they may have chronic pain due to other clinical situations, which can confuse their evaluation in the postoperative period [8], there may be a limitation in using analgesics due to fear of adverse effects, and often, the elderly refrain from reporting their pain to avoid disturbing the care team [9]
In a study conducted in the United States that compared postoperative pain at different ages, elderly patients had more pain and received more analgesics [11]

Summary

Introduction

Postoperative pain (POP) remains a major challenge for surgeons and anesthesiologists worldwide, especially in low- and middle-income countries, due to important limitations, such as technological and human resources and availability of analgesics [1,2,3,4].POP incidence available in the literature usually reflects data from specific surgeries or reflects regional realities and, presents great variability, showing averages ranging from 14–62% [1,2,5,6]. When looking for data from low- and middle-income countries, these numbers are scarce and frequently come from single-center or small samples studies [1,2,4,7] Due to their specific characteristics, some populations have a higher risk of having their pain poorly evaluated, and undertreated. The elderly population accumulates different aspects that lead to a greater risk of POP: they may have chronic pain due to other clinical situations, which can confuse their evaluation in the postoperative period [8], there may be a limitation in using analgesics due to fear of adverse effects, and often, the elderly refrain from reporting their pain to avoid disturbing the care team [9]. The confounding factors described earlier could be avoided

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Methods

Results