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老年人群的区域麻醉

Regional anesthesia for geriatric population.

作者信息

Al Harbi Mohammed K, Alshaghroud Salah M, Aljahdali Mohammed M, Ghorab Fadi A, Baba Fayaz, Al Dosary Rayan, Bahadeq Mohammed

机构信息

King Abdullah International Medical Research Center, Riyadh, KSA.

King Saud Bin Abdulaziz University for Health Science, Riyadh, KSA.

出版信息

Saudi J Anaesth. 2023 Oct-Dec;17(4):523-532. doi: 10.4103/sja.sja_424_23. Epub 2023 Aug 18.

Abstract

Advancements in modern health care over 20 years have substantially increased the average lifespan in developed countries, and the fastest growing population is the elderly population. The proportion of people in Saudi Arabia aged 60 or more is predicted to be 25 percent of the total population of 40 million by the end of 2050. Moreover, the number of people aged 80 or more is expected to reach 1.6 million or 4 percent of the total population in the same period. Improvements in surgical techniques, anesthesia, and intensive care units make surgical interventions in older and sicker patients possible. It is estimated that over half of the population older than 65 years will require surgical intervention at least once during the remainder of their lives. Therefore, elderly patients are becoming an even larger part of anesthetic practice. Regional anesthesia (RA) is frequently used in elderly patients, especially during orthopedic surgery, genitourologic and gynecologic procedures, and hernia repair. Although age can no longer be considered a contraindication to anesthesia and surgery, anesthesia-related morbidity and mortality remain higher among elderly than among young adult surgical patients. Undoubtedly, peripheral nerve (PN) blocks improve analgesia and reduce opioid consumption and their associated side effects. This is beneficial in the perioperative care of elderly patients who may have less physiologic reserve to withstand the side effects of general anesthesia (GA).

摘要

20年来现代医疗保健的进步大幅提高了发达国家的平均寿命,增长最快的人群是老年人群体。预计到2050年底,沙特阿拉伯60岁及以上人口的比例将占4000万总人口的25%。此外,80岁及以上人口的数量预计同期将达到160万,占总人口的4%。手术技术、麻醉和重症监护病房的改进使对老年和病情较重患者进行手术干预成为可能。据估计,超过65岁的人群中有一半以上在其余生中至少需要接受一次手术干预。因此,老年患者在麻醉实践中所占的比例越来越大。区域麻醉(RA)常用于老年患者,尤其是在骨科手术、泌尿生殖系统和妇科手术以及疝气修补术中。虽然年龄不再被视为麻醉和手术的禁忌证,但老年患者麻醉相关的发病率和死亡率仍高于年轻成人手术患者。毫无疑问,外周神经(PN)阻滞可改善镇痛效果,减少阿片类药物的使用及其相关副作用。这对可能生理储备较少、难以承受全身麻醉(GA)副作用的老年患者围手术期护理有益。

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