Abstract: Objective To investigate the management and usage of analgesic pumps after thoracoscopic surgery in the elderly in order to identify the risks and provide reference for postoperative analgesia and interventions by clinical pharmacists. Methods The usage of analgesic pumps after thoracoscopic (partial) lobectomy among elderly patients treated in our hospital between January 1, and October 31, 2020 was retrospectively analyzed. The basic information about these patients, analgesic scores, analgesic methods in different steps of postoperative analgesia, usage of analgesic drugs and adverse reactions were recorded before fishbone diagrams were used to analyze the causes of risks and propose precautions. Results A total of 114 cases were included, whose age averaged (67.64±5.83) years. The types of non-steroidal drugs used in all cases were(2.12±0.64). Cases of combined use of two NSAIDs or more accounted for 85.09% of the total. The average length of parecoxib use was(5.46±2.76) days. There were also cases of overdose of parecoxib and flurbiprofen. During postoperative analgesia, 36 patients (31.58%) developed nausea and vomiting, 5 patients (4.39%) dizziness and 2 (1.75%) pruritus, all of which were mitigated after symptomatic treatment. Brainstorming and fishbone diagram analysis showed that the risks were probably due to the lack of standard handover processes, a multidisciplinary pain management team, intelligent reminders of doctors’ orders and pre-review, and re-organization of analgesic drugs. Conclusion This type of patient needs to stay in different rooms after surgery. During postoperative analgesia, there is a lack of communication between all these links, leading to the high rate of repeated use of non-steroidal drugs and overdose. Hospitals should improve the communication between all the related links and establish a multidisciplinary pain management team and an information-based risk warning system, while clinical pharmacists can innovate the organization of analgesic drugs.

Key words: elderly patients, analgesia, risk investigation, risk prevention