Luger Markus F, Luger Thomas J
Klinik für Anästhesiologie und Allgemeine Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
Anaesthesist. 2017 May;66(5):375-392. doi: 10.1007/s00101-017-0323-3.
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification. If necessary additional investigations, such as echocardiography must be carried out, in order to guarantee optimal perioperative anesthesiological management. Certain medical factors can delay the initiation of anesthesia and it is absolutely necessary that these are taken into consideration for surgical management. Not every form of anesthesia is equally suitable for every geriatric patient.
老年患者越来越需要在麻醉下接受手术,尤其是在创伤后。对这些患者进行围手术期管理采取及时的多学科方法对长期预后至关重要。老年骨科联合管理,早期就包括老年病科医生和麻醉医生,对老年患者大有裨益。患者年龄、合并症和日常生活自理能力对健康状况的麻醉学评估和术前风险分层起决定性作用。如有必要,必须进行额外检查,如超声心动图检查,以确保围手术期麻醉管理达到最佳效果。某些医学因素会延迟麻醉的开始,手术管理绝对有必要考虑这些因素。并非每种麻醉方式都同样适用于每位老年患者。