The Practice of Geriatric Anesthesia

Abstract

The approach to and management of surgery and anesthesia in geriatric patients is different and frequently more complex than in younger patients. In caring for the elderly in the operating room, recovery room, and intensive care unit, the members of the perioperative medical team should be aware of the nature of aging physiology, the interaction of these alterations with pathologies, and the likelihood of multiple diagnoses and polypharmacy. The context of geriatric care encompasses multiple levels, stretching from primary care, through acute hospitalization, acute and subacute rehabilitation, nursing home care, and hopefully back to sufficient function to require additional primary care. By the nature of their practices, anesthesiologists and geriatricians have different approaches to patient care and the time frame over which such care occurs. In communicating with patients and geriatricians, one should understand that expectations for recovery are frequently different than in younger patients, marked by issues of maintenance of function and independence.