Table 1.

A variety of common analgesics used for postoperative pain management during colorectal surgery in the elderly

Analgesic drugs	Mechanism of action	Advantages	Disadvantages
NSAIDs	Inhibits cyclooxygenase-1 and cyclooxygenase-2	Especially suitable for inflammatory pain; reduces the consumption of opioids, improves bowel recovery time, reduces postoperative hospital complications, and shortens the length of hospital stays	May increase the rate of postoperative anastomotic leakage, may lead to decreased renal function and dose-dependent heart failure or acute myocardial infarction
Acetaminophen	Acts on the transient receptor potential vanilloid 1 (TRPV1) and cannabinoid 1 receptors	Fewer gastrointestinal and renal side effects, reduces opioid consumption, length of hospital stays, reduces the incidence of intestinal obstruction, and promotes intestinal function recovery	Lack of anti-inflammatory effect, may increase the risk of gastrointestinal bleeding, Overdose may lead to severe hepatotoxicity and acute
Lidocaine	Reversibly blocks voltage-gated sodium channels	Reduces nausea and vomiting, duration of intestinal obstruction, opioid consumption, and length of hospital stays, and accelerates the recovery of gastrointestinal function, induces apoptosis, and inhibits proliferation of colorectal tumor cells	Overdose may lead to systemic toxicity affecting the central nervous system (drowsiness, convulsions) and cardiovascular system (arrhythmias, cardiac arrest)
α2 adrenergic agonists	Acts on α2 receptors in the central and spinal cord	Accelerates the recovery of gastrointestinal function, reduces systemic inflammatory response, and reduces the incidence of postoperative delirium	May cause hypotension, bradycardia
Gabapentinoids	Binds to the voltage-dependent calcium channel α2δ subunit	Reduces the consumption of opioids, prevents postoperative nausea and vomiting	Increases the risk of postoperative delirium, excessive sedation, respiratory depression, and multidrug treatment with newer antipsychotics