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ANESTHESIA ALERT
Nina Singh-Radcliff, MD
Anesthesia Safety for the Elderly
Pearls to prevent complications among your older patients.
W
ith more
DECREASED BLOOD PRESSURE Elderly patients are at risk for hypotension and
ischemia, which can lead to arrhythmias and congestive heart failure.
and more
elderly
patients presenting for
same-day surgery,
now's a good time to
consider the unique
risks of geriatric anesthesia. Not only have
the organs in your
older patients begun
their steady decline of functional reserve, but also you're likely to see
hypertension, diabetes, and coronary and cerebrovascular disease.
From strokes to dementia, here's how to avert dangerous situations.
What to watch for
From a physiological standpoint, cerebral blood flow and volume are
decreased in geriatric patients. This is due to a combination of reduced
cerebral metabolism and vascular changes, which include atherosclerosis and decreased vessel wall compliance. What to watch for:
• Stroke. The risk of stroke doubles each decade after age 55. For men,
the 10-year probability of having a stroke is 5.9% at age 55. The risk more
than doubles to 13.7% at 70, and increases again to 22.3% at age 80.
• Dementia. The risk of dementia increases to 10% for patients 65 and
over, and at age 80, 20% of patients have some degree of dementia.
• Hearing loss. Additionally, 20% of 50-year-old and 90% of 80-year-old
patients experience some level of hearing loss, which can lead to social
isolation and paranoid ideation.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U N E 2013
