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Anesthesia

Basics Of Anesthesia, The Unique Challenge Of The Elderly Patient, Preoperative Assessment, Intraoperative ManagementConclusion

"My diseases are an asthma and a dropsy and, what is less curable, seventy-five."

—Samuel Johnson.

Over 40 percent of all surgical procedures in the United States are performed on patients over age sixty-five, a remarkable statistic given that those over sixty-five comprise only 13 percent of the U.S. population. Elderly patients are more likely than their younger counterparts to suffer serious medical complications such as a heart attack, pneumonia, or kidney failure during or after an operation, further compounding the impact that caring for elderly patients has on the medical system.

The anesthetic care of the elderly patient is complex and demanding because of the effects of aging on organ function, plus the greater likelihood of chronic disease with increased age. Greater attention must be afforded such patients, beginning with the evaluation and optimization of the patient's medical status. The anesthetic requires close attention to detail, and, in selected patients, special techniques may be useful in lowering the risk of complications.

G. ALEC ROOKE

BIBLIOGRAPHY

LIU, S.; CARPENTER, R. L.; and NEAL, J. M. "Epidural Anesthesia and Analgesia—Their Role in Postoperative Outcome." Anesthesiology 85 (1995): 1474–1506.

MCLESKEY, C. H., ed. Geriatric Anesthesia. Baltimore, Md.: Williams & Wilkins, 1997.

MOLLER, J. T.; CLUITMANS, P.; RASMUSSEN, L. S.; et al. "Long-Term Postoperative Cognitive Dysfunction in the Elderly: ISPOCD1 Study." Lancet 351 (1998): 857–861.

MORGAN, G. E., and MIKHAIL, M. S. Clinical Anesthesia, 2d ed. New York: Lange Medical Books/McGraw-Hill, 1996.

MURAVCHICK, S. Geroanesthesia. St. Louis, Mo.: Mosby, 1997.

ROOKE, G. A. "Autonomic and Cardiovascular Function in the Geriatric Patient." Anesth Clin NA 18 (2000): 31–46.

TIRET, L.; DESMONTS, J. M.; HATTON, F.; and VOURC'H, G. "Complications Associated with Anesthesia—A Prospective Survey in France." Canadian Anaesthetists' Society Journal 33 (1986): 336–344.

ANEURYSM, ABDOMINAL AORTIC

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ANNUAL CHECK-UP

See PERIODIC HEALTH EXAMINATION

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Medicine EncyclopediaAging Healthy - Part 1