Akhtar Shamsuddin, Ramani Ramachandran
Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, Tompkins # 3, New Haven, CT 06520, USA.
Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, Tompkins # 3, New Haven, CT 06520, USA.
Anesthesiol Clin. 2015 Sep;33(3):457-69. doi: 10.1016/j.anclin.2015.05.004. Epub 2015 Jul 7.
Aging involves changes in several physiologic processes that lead to decreased volumes of distribution, slowed metabolism, and increased end-organ sensitivity to anesthetics. These changes generally result in increased potency. Elderly patients require less anesthetic medication, but the true extent of reduction is underappreciated and less uniformly practiced. The impact of potential anesthetic drug overdosing on intermediate and long-term outcomes is not fully appreciated. It may be necessary to consider age as a continuous variable for anesthetic drug dosing in older patients rather than treating adult versus elderly patients. Further pharmacologic studies are required in people more than 85 years old.
衰老涉及多个生理过程的变化,这些变化会导致分布容积减小、代谢减慢以及终末器官对麻醉药的敏感性增加。这些变化通常会导致效能增加。老年患者所需的麻醉药物较少,但实际减少的程度并未得到充分认识,且实践中也缺乏一致性。潜在的麻醉药物过量对中期和长期预后的影响尚未得到充分认识。对于老年患者的麻醉药物给药,可能有必要将年龄视为一个连续变量,而不是区分成年患者和老年患者。需要对85岁以上的人群进行进一步的药理学研究。