Lester Laeben
Division of Cardiothoracic Anesthesia, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, 1800 Orleans Street, Zayed 6208, Baltimore, MD 21287-7294, USA.
Anesthesiol Clin. 2015 Sep;33(3):491-503. doi: 10.1016/j.anclin.2015.05.006. Epub 2015 Jul 7.
The elderly population is growing. Geriatric patients undergo a large proportion of surgical procedures and have increased complications, morbidity, and mortality, which may be associated with increased intensive care unit time, length of stay, hospital readmission, and cost. Identification of optimal anesthetic care for these patients, leading to decreased complications and contributing to best possible outcomes, will have great value. This article reviews the anesthetic considerations for intraoperative care of geriatric patients and focus on 3 procedures (hip fractures, emergency abdominal surgery, and transcatheter aortic valve replacement). An approach to evaluation and management of the elderly surgical patient is described.
老年人口正在增长。老年患者接受了很大比例的外科手术,并且并发症、发病率和死亡率有所增加,这可能与重症监护病房时间延长、住院时间、医院再入院率和成本增加有关。确定针对这些患者的最佳麻醉护理方案,从而减少并发症并促成尽可能好的结果,将具有重大价值。本文回顾了老年患者术中护理的麻醉注意事项,并重点关注3种手术(髋部骨折、急诊腹部手术和经导管主动脉瓣置换术)。文中描述了一种评估和管理老年外科患者的方法。