Kratz C D, Schleppers A, Iber T, Geldner G
Klinik für Anästhesie und Intensivtherapie, Klinikum der Philipps-Universität, Marburg.
Anaesthesist. 2005 May;54(5):467-75. doi: 10.1007/s00101-005-0810-9.
Because of demographic developments, the fraction of the German population over 65 years of age in the year 2025 will have risen to 20% and will continue to rise so that in 2030 this number will have doubled compared to today's numbers. This has a huge impact on the requirements for anaesthesiologic procedures. In addition to the frequent multi-morbidity in this age group, physiologic changes also occur in the elderly which have to be taken into consideration during the entire perioperative management of these patients. Renal, cardiovascular and hepatic function are impaired in many elderly patients. A major concern in addition to cardiovascular and operative complications is the postoperative cognitive dysfunction (POCD), not only because of its implications for the patient but also because of economical consequences. Regional anaesthesia has some benefits when compared to general anaesthesia as it leads to a reduction in thromboembolic and respiratory complications.
由于人口结构的变化,到2025年,德国65岁以上人口的比例将升至20%,并将持续上升,到2030年,这一数字将比目前翻一番。这对麻醉程序的需求产生了巨大影响。除了该年龄组常见的多种疾病外,老年人还会出现生理变化,在这些患者的整个围手术期管理过程中必须予以考虑。许多老年患者的肾功能、心血管功能和肝功能都有所受损。除了心血管和手术并发症外,术后认知功能障碍(POCD)也是一个主要问题,这不仅是因为它对患者的影响,还因为其经济后果。与全身麻醉相比,区域麻醉有一些益处,因为它可减少血栓栓塞和呼吸系统并发症。