Recent advances in geriatric anaesthesia

Abstract

The World Health Organization defines healthy ageing as ‘the process of developing and maintaining the functional ability that enables well-being in older age’. This functional ability is the characteristic of the individual’s own physical and mental status influenced by the environmental and socio-economic factors. Preoperative preparation of the elderly patients includes functional assessment to identify preexisting cognitive impairment or cardio-pulmonary reserve, frailty, nutrition, polypharmacy and anti-coagulation issues. Intraoperative management includes anaesthetic mode and pharmacology, monitoring, intravenous fluid and transfusion management, lung protective ventilation and hypothermia. Postoperative checklist includes perioperative analgesia, postoperative delirium and cognitive dysfunction.

A retrospective analysis of postoperative geriatric patients with hip fracture; the reasons for admission to ICU

“…22 Within the framework of the ERAS protocol, it is recommended that elderly patients should be operated under regional anesthesia with opioid-limited anesthesia. 23 In our clinic, regional anesthesia is chosen as much as possible in accordance with this protocol and opioids are not preferred for sedation in elderly patients.…”

The Reliability of Carotid Artery Doppler Ultrasonography Indices in Predicting Fluid Responsiveness during Surgery for Geriatric Patients: A Prospective, Observational Study

“…These changes highlight the importance of understanding age-related vascular changes in clinical practice and management [2]. Consequently, it becomes imperative to ascertain patients' intravascular fluid status and responsiveness to fluid interventions since alterations in intercompartmental fluid exchange during surgery can result in exacerbated fluctuations in cardiac filling pressure [3]. Both hypovolemia and fluid overload can potentially have fatal consequences in this patient population.…”

Innovative research and technological advancements: Oars of the boat of progress

“…In addition to ultrasound, the modern anaesthesiologist is equipped with modern tools such as risk prediction tools, models, and indices which can be applied to identify the high-risk surgical patient. [ 11 , 12 ] The postoperative behaviour and outcomes of the patient are thus no longer a suspense to the operating team and the patient’s attenders. Early warning scores, algorithms, and indices help to detect early chances of clinical deterioration in the ICU, in the detection of sepsis, and in the management of postpartum haemorrhage (PPH), eg-The obstetric early warning scores and the shock index have been used to recognise and predict severe haemorrhage and the need for blood transfusion.…”