Perioperative Care of Elderly Surgical Patients

Abstract

Advancing age is characterized by functional impairment of the many regulatory processes that provide integration between organs and therefore, may lead failure to maintain homeostasis under conditions of physiological stress. There are two main factors helping to identify the high risk for surgery. The first relates to the type of surgery and the second to the scope of cardiopulmonary functional capacity of the patient. There are major cardiovascular, respiratory, renal and musculoskeletal changes in elderly patients. Preoperative assessment of risk in elderly patients must consider patient factors, the surgical problem and the treatment options. Medical co-morbid conditions are common with age and may markedly increase the risks associated with surgical intervention. Postoperative care of elderly includes respiratory Care, renal function and fluid and electrolyte management, cardiovascular Care, management of pain and maintenance of function. In conclusion, health providers should pay attention to the quality of care in elderly patients because they are vulnerable surgical and anaesthetic stress. Minimizing perioperative risk in those patients requires thoughtful preoperative assessment of organ function and reserve, meticulous intraoperative management and postoperative care. Management of surgical elderly patients is both complex and different from younger patients. Assessment of the surgical problems and physiologic status of elderly persons must take into account the changes associated with advancing age, changes in the incidence, prevalence and natural history of certain disease processes; and the increased likelihood of multiple medical diagnoses and polypharmacy.