The Aging Respiratory System: Anesthetic Strategies to Minimize Perioperative Pulmonary Complications

Spirometric values and chest pain intensity three days post-operative coronary artery bypass graft surgery

“…Cutting of skin, muscles and pleura, retraction of muscles and ligaments, and pleural and septal nerve irritation from thoracic drains during CABG cause post-operative chest pain [34]. This pain interrupts the normal mechanics of breathing and results in poor ventilation confirmed by commonly occurring atelectasis [4] after CABG and alteration of breathing pattern into shallow rapid breathing [4,25]. Reduction of spirometric values is the logical consequence of poor ventilation and abnormal breathing pattern.…”

“…Postoperative care-related factors include use of pain control and narcotic medications [10,24]. The hypothesis behind post-operative chest pain as a related factor of post-operative ventilatory complications and reduced spirometric values is that pain causes chest wall dysfunction which limits the voluntary actions of the chest wall respiratory muscles and causes breathing to become rapid and shallow [4,25].…”

Global ageing is a growing problem for anaesthesiologists: A case of regional blocks in a geriatric patient

“…Ageing population steadily increases all around the world. These population require meticulous medical evaluation: their risk factors have to be well described and perioperative management and postoperative care have to be planned (4). Elderly patients who present to emergency services due to a trauma also have chronic diseases (such as cardiac disease, diabetes mellitus, chronic obstructive pulmonary disease).…”

“…These techniques affect early-and late-term morbidity and mortality in high risk geriatric patients. There are some studies show that regional anaesthetic techniques associated with fewer cerebrovasculer accidents, and reduced acute postoperative confusion in orthopedic surgery (4,7,8). Also, regional anaesthesia reduce blood loss, improve peripheral vascular circulation, suppress surgical stress response and provide better post-operative pain control via blocking afferent and efferent signals to and from the spinal cord.…”

Perioperative management of patients with respiratory failure

“…Пожилой и старческий возраст, таким образом, не может быть причиной отмены оперативного вмешательства. Следует помнить о том, что у пожилых людей часто встречаются вялотекущие и трудно диагностируемые заболевания [16].…”