(BPT) - Opioid overdose deaths among people 65 and older have surged by 9,000% in less than a decade. Most children fast longer than needed before surgery. And women who have C-sections may have pain that disrupts sleep for months. These were among the findings - aimed at exploring trends that could improve care for patients of all ages - unveiled at ANESTHESIOLOGY® 2025, the annual meeting of the American Society of Anesthesiologists (ASA).
"These studies highlight how anesthesiologists can make health care safer, more comfortable and more effective at every age," said ASA President Patrick Giam, M.D., FASA. "From reducing and monitoring opioid use in older people, to ensuring parents safely and appropriately give their children clear liquids before surgery, to easing pain after C-sections so mothers can sleep and recover, anesthesiologist-led research continues to drive innovation and improve outcomes in medicine."
Here are a few of the important findings anesthesiologists presented at ANESTHESIOLOGY 2025.
Adults 65 Years and Older Not Immune to the Opioid Epidemic
While the opioid epidemic previously affected mostly younger people, seniors are now experiencing surging opioid overdose rates. In fact, overdose deaths in people age 65 and older from fentanyl mixed with stimulants have risen by 9,000% in less than a decade, according to an analysis of more than 400,000 fentanyl-related deaths collected by the Centers for Disease Control and Prevention (CDC).
Nearly half of the deaths involved mixing fentanyl with stimulants, such as cocaine or methamphetamines. Older adults are especially at risk because many have chronic health conditions, take multiple medications and metabolize drugs more slowly, according to Gab Pasia, M.A., lead author of the study and a medical student at the University of Nevada, Reno School of Medicine.
While opioids are effective for pain control, they should be used sparingly, especially in older people, researchers cautioned. They note that anesthesiologists and other pain medicine specialists should choose other pain management methods when possible and carefully monitor older patients when prescribing opioids. That includes educating them and their caregivers on overdose prevention tools such as naloxone.
Children Fast From Clear Liquids Much Longer Before Surgery Than Guidelines Recommend
More than two-thirds of children and nearly 80% of infants forgo clear liquids before surgery for at least twice as long as guidelines recommend, according to a study of more than 71,000 children aged 17 or younger.
Healthy infants and children may safely drink clear liquids until two hours before receiving anesthesia, according to current ASA guidelines. Yet researchers found that on average, children over a year old go without clear fluids for nearly nine hours before surgery - more than four times longer than needed. Infants go without clear fluids on average more than six hours before surgery.
Parents may worry about giving their child anything to drink before surgery due to the risk of liquid entering the lungs, but allowing children to drink clear liquids up to two hours before surgery is generally safe and helps prevent problems such as dehydration and low blood sugar, according to Alexander Nagrebetsky, M.D., M.Sc., senior author of the study and an anesthesiologist and intensivist at Massachusetts General Hospital, Boston and assistant professor at Harvard Medical School, Cambridge, Massachusetts.
Parents should talk with their anesthesiologist before surgery to confirm the latest fasting guidance and ensure their child stays hydrated and safe. For example, most children are encouraged to drink water or sugar-containing clear liquids, such as fruit juices without pulp or those with electrolytes, for up to two hours before the start of the procedure, Dr. Nagrebetsky noted.
Cesarean Delivery Linked to Higher Risk of Pain and Sleep Problems After Childbirth
Women who have a cesarean delivery (C-section) may be more likely to experience ongoing pain and sleep problems after childbirth compared to those who have a vaginal delivery, according to a nationwide analysis of more than 1.5 million mothers.
Individuals who had C-sections are 16% more likely to be diagnosed with a new sleep disorder in the first year after giving birth, compared to those who have vaginal births, according to Moe Takenoshita, M.B.B.Ch., lead author of the study and a postdoctoral scholar in the department of anesthesia at Stanford University Center for Academic Medicine, Palo Alto, California. Additionally, in interviews with 41 mothers who had C-sections, more than two-thirds said the pain disrupted their sleep and activities of daily living.
New mothers, especially those recovering from C-sections, should manage their pain to help them get better sleep and discuss any concerns with their physician. Getting regular exercise as appropriate, sleeping when the baby sleeps and avoiding caffeine late in the day can also help.
To learn more about the importance of physician-led anesthesia care - including how anesthesiologists keep patients safe before, during and after surgery - and explore the latest advances in the specialty, visit: https://www.asahq.org/madeforthismoment/.
