Anästhesiologie des alten Patienten – Besonderheiten und diverse Methoden

Abstract

Anesthesia of Elderly Patients – Peculiarities and Diverse Methods The share of older individuals is the fastest growing sector in our population. It is widely accepted that there are enormous differences between chronological and biological age. The elderly patient is characterized by an ongoing decrease of general and reserve functional capacity of each organ system. These changes might be tolerable and not decreasing quality of daily life, but become obvious during an exceptional situation, e.g. a surgical intervention or an infection. Interacting comorbidities and changes in the cardiovascular, pulmonary, hepatorenal or neuromuscular state require an exact treatment strategy, ranging from the preoperative risk assessment and optimization to optimal intraoperative treatment in view of a decreased reserve functional capability. Tachycardia, excessive changes in blood pressure and blood glucose levels, hypothermia, and of course hypoxia should be avoided in all cases. Postoperative continuation of careful blood and fluid substitution, pain therapy, and above all a careful contact with the elderly patient help to guarantee a perfect result – an early reintegration into their earlier surrounding. The necessity of modern intensive care should be evaluated and organized in advance. Medical progress, short acting, well controllable drugs for general and regional anesthesia as well as modern less invasive monitoring and treatment facilities enable physicians to treat the steadily ageing population. Clinical experience as well as scientific results show clearly that advanced age is associated with an increased perioperative morbidity and mortality risk. Aware of the physiological changes and mastering modern diagnostic and therapeutic facilities, we are proudly to say that advanced chronological age per se is no longer a contraindication for a surgical intervention.