General and local anesthetics

Abstract

As the elderly population continues to increase and surgical techniques and management continue to improve, the number of elderly surgical patients will continue to grow. An aging population carries profound implications for the practice of anesthesiology. Geriatric issues impact every aspect of anesthesiology. The preoperative evaluation of the geriatric patient is typically more complex than that of the younger patient because of the heterogeneity of this patient group and the greater number and complexity of comorbid conditions that usually accumulate with age. An understanding of general concepts of human aging and of organ function in older adults may contribute to adequate perioperative management of the elderly patient. One of the most important manifestations of aging is increased sensitivity to internal and external environmental stressful stimuli. With an acute disease or a surgical procedure, the elderly may be more prone to complications given their diminished reserve capacity and decreased ability to respond to the demand. Normal aging results in changes in cardiac, respiratory, and renal physiology. Because of physiologic heterogeneity, the response of the elderly patient to surgical stress is often unpredictable. © 2010 Springer-Verlag London.