Anesthesia Student Survival Guide.pdf - Index of

Physiology and Anesthesia
for Elderly Patients
Ruma Bose
Chapter 23
For maximum impact, it is recommended that the case study and questions found
on page xxix are reviewed before reading this chapter.
Key Learning Objectives
● Understand the physiologic changes associated with aging
● Learn the specific considerations for anesthetic management of the elderly
● Understand common postoperative anesthetic complications
The elderly is defined as a person who is over the chronological age of 65 years.
This includes a large number of people with varying physical and mental
capabilities. However, the basis for defining 65 years as a threshold for old age
is still not well-defined. Aging is a natural biological process which is associated
with a normal decline in physiological function. In addition, the functional
reserve decreases with age, which impacts on the ability of the elderly to recover
from major illnesses, surgery, and trauma.
Care of the elderly requires knowledge of the normal age-associated physiologic
changes and age-related illnesses. The preoperative management should be
focused on identifying and optimizing any comorbid conditions prior to surgery.
During the intraoperative phase, one should take into consideration the physiological
changes that occur in the elderly. This often requires the use of shorter acting
agents and additional invasive monitoring to maintain hemodynamic stability.
Postoperative care should be focused on early identification and treatment of postoperative
complications such as postoperative delirium, hypoxia, and hypotension.
J.M. Ehrenfeld et al. (eds.), Anesthesia Student Survival Guide: A Case-Based Approach,
DOI 10.1007/978-0-387-09709-1_23, © Springer Science+Business Media, LLC 2010
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