Perioperative Care of the Elderly
SUMMARY
The geriatric population is growing in number and complexity in modern surgical practice. This challenging group presents differences in physiology and outcomes that make a more comprehensive and multidisciplinary approach necessary. This review emphasizes the meticulous assessment and preparation in all facets before surgery, including a thorough examination, nutrition evaluation and intervention, and preoperative optimization of pulmonary function and cardiovascular hemodynamics. This article highlights the importance of age-related pharmacokinetic and pharmacodynamic considerations, effective pain control, as well as prevention and treat-ment of hypothermia, fluid and electrolyte imbalance, and postoperative delirium. The vulnerable elderly patient with multiple medical problems and functional impairment is best served by a surgeon with a particular interest and working knowledge of the changes associated with aging and the physiology of surgery and anesthesia.
Key Words: age factors , geriatrics , risk assessment , surgery
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PII: S1873-9598(08)70028-0
doi:10.1016/S1873-9598(08)70028-0
© 2007 Elsevier B.V. All rights reserved.
