In Reply We thank Pivalizza et al and Zhao et al for their interest in our work1 as it provides the opportunity to provide more detail. Pivalizza et al suggested the importance of involving anesthesia. We strongly agree that having anesthesiology as part of the multidisciplinary team effort in caring for geriatric trauma patients is not only important but necessary for optimal geriatric pain management. In fact, one of the coauthors on our article1 is an anesthesiologist. As Pivalizza and colleagues noted, pain management strategies need to be opioid sparing, and regional/local anesthetics play an important role in achieving pain control while minimizing medication adverse reactions. Anesthesiologists have been critically important members of our team throughout our program. For one, we worked with anesthesiologists to develop geriatric-specific pain guidelines that are integral to the multidisciplinary geriatric trauma care pathway. Anesthesiologists on our pain service also partner with both the trauma surgery and geriatric medicine groups as well as nursing and pharmacy to ensure delivery of the safest and most effective pain management plan possible to older adults.