Aurini Lucia, White Paul F
aAnesthesiology and Intensive care Department, Bologna University, Bologna, Italy bDepartment of Anesthesia, Cedars-Sinai Medical Center in Los Angeles, Los Angeles, California, USA *Visiting Scientist at the Rizzoli Instituto at the University of Bologna, Italy.
Curr Opin Anaesthesiol. 2014 Dec;27(6):563-75. doi: 10.1097/ACO.0000000000000135.
As the number of ambulatory surgery procedures continues to grow in an aging global society, the implementation of evidence-based perioperative care programs for the elderly patients will assume increased importance.
Increasing evidence supports the expanded use of ambulatory surgery for managing elderly patients undergoing elective surgery procedures.
This review article describes the demographics of ambulatory surgery in the elderly population. This review article describes the effects of aging on the responses of geriatric patients to anesthetic and analgesic drugs used during ambulatory surgery. Important considerations in the preoperative evaluation of elderly outpatients with co-existing diseases, as well as the advantages and disadvantages of different anesthetic techniques on a procedural-specific basis, and recommendations regarding the management of common postoperative side-effects (including delirium and cognitive dysfunction, fatigue, dizziness, pain, and gastrointestinal dysfunction) after ambulatory surgery. Finally, we discuss the future challenges related to the continued expansion of ambulatory surgery practice in this growing segment of our surgical population. The role of anesthesiologists as perioperative physicians is of critical importance for optimizing surgical outcomes for elderly patients undergoing ambulatory surgery. Providing high-quality, evidence-based anesthetic and analgesic care for elderly patients undergoing elective operations on an ambulatory basis will assume greater importance in the future.
在全球老龄化社会中，随着门诊手术数量持续增加，为老年患者实施基于证据的围手术期护理计划将变得愈发重要。
越来越多的证据支持扩大门诊手术在管理接受择期手术的老年患者中的应用。
本文综述描述了老年人群门诊手术的人口统计学特征。本文综述描述了衰老对老年患者在门诊手术期间对麻醉和镇痛药物反应的影响。对患有并存疾病的老年门诊患者进行术前评估时的重要考虑因素，以及基于特定手术的不同麻醉技术的优缺点，还有关于门诊手术后常见术后副作用（包括谵妄和认知功能障碍、疲劳、头晕、疼痛和胃肠道功能障碍）管理的建议。最后，我们讨论了在这一不断增长的手术人群中门诊手术实践持续扩大所带来的未来挑战。麻醉医生作为围手术期医生的角色对于优化接受门诊手术的老年患者的手术结果至关重要。未来，为接受择期门诊手术的老年患者提供高质量、基于证据的麻醉和镇痛护理将变得更加重要。
