Geriatric anesthesia in an aging society

Jong Wha Lee; Ki-Young Lee

doi:10.5124/jkma.2011.54.3.303

J Korean Med Assoc > Volume 54(3); 2011 > Article

Lee and Lee: Geriatric anesthesia in an aging society

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(3): 303-310.

Published online: March 16, 2011

DOI: http://dx.doi.org/10.5124/jkma.2011.54.3.303

Geriatric anesthesia in an aging society

Jong Wha Lee, MD, Ki-Young Lee, MD

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Ki-Young Lee, kylee504@yuhs.ac

Received January 07, 2011 Accepted January 21, 2011

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aging is a process of the gradual reduction of functional reserve, and when it begins and how fast it proceeds are different from patient to patient. Therefore, it is important to thoroughly evaluate the current status of an elderly patient. Based on an in-depth understanding of pharmacokinetic and pharmacodynamic changes that occur due to aging, sophisticated titration of doses and infusion rates of drugs depending on the current functional status of the patient is essential for hemodynamic stability. Physicians must always keep in mind that the top priority of geriatric anesthetic management is the rapid return of functional independence. Therefore, wher-ever practical, it is prudent to use drug(s) of short duration, and metabolic processes not affected by the current disease and/or the proposed surgical procedures. Active preoperative assessment of cardiac and cerebrovascular risk factors and adequate postoperative pain relief are important to prevent postoperative cognitive dysfunction, which delays functional recovery.

Aging; Anesthesia; Elderly patient

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