Anaesthesia in the elderly patients


Who is considered as an “eldery patient” nowadays? Statisticaly it is age of 65 years. There were 1 760 000 citizens of this age group in the Czech republic at the 31th December 2012, which is nearly 17 % of our population. The pensionable age is 66.5 years. It is claimed that 22 % of all surgeries are among the eldery patients regarding the same date and this number is rising. Higher risk of perioperative morbidity is connected with higher age and so there are important specifics of anesthesia in eldery patients. What kind of specifics? 

2017
anaesthesia
comorbidities
dose of anaesthetics
functional reserve
Published at: 25.5.2017

Review

Michal Horáček, MD
Department of Anaesthesiology and Intensive Care Medicine, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital

The proper health treatment of an elderly person with head and lower limb injuries caused by fall, who has been brought to the emergency at Saturday night can be very challenging. You should not forget about any other health conditions, which might not seem so apparent at the very first time beside the obvious surgical problem. The associated complicating diseases and chronical medication, such as warfarine, bring many more internal issues along. And if you succeed with patient intake process, you will change your specialization from a traumatologist to an anaesthesiologist and you will face many different problems during anaesthetic care, whether you choose for general or spinal anaesthesia. But careful! There is no space for mistakes in care of this fragile patient!
Enjoy this algorithm, Saturday night starts right now and another ambulance might be at the hospital gate.

Sources

BARASH, Paul G. et al. Handbook of clinical anesthesia. 1. edition. Praha: Grada, 2014. 804 s.

Česká lékařská společnost J. E. Purkyně et al. Novinky v anesteziologii, intenzivní medicíně a léčbě bolesti. 1. edition. Praha: Galén, 1999

BARNETT, Sheila. Anesthesia for the older adult. [online]. Harvard Medical School. Aug 10, 2016. Available at http://www.uptodate.com/contents/anesthesia-for-the-older-adult?source=search_result&search=anesthesia+for+the+elderly&selectedTitle=1%7E150

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