Advertisement

Research Priorities in Geriatric Anesthesiology

  • Christopher J. Jankowski
  • David J. Cook

Abstract

The implications of an aging population on the practice of anesthesiology are profound. Normal aging results in diminished functional reserve across organ systems. These normal physiologic changes and age-related disease combine to limit the ability of the elderly to tolerate the stress of the perioperative period. Thus, geriatric issues affect every aspect of the care provided by the anesthesiologist.

Keywords

Herpes Zoster Epidural Analgesia Adverse Drug Event Complex Regional Pain Syndrome Postherpetic Neuralgia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Franklin SS, Gustin WT, Wong ND, et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997;96:308–315.PubMedGoogle Scholar
  2. 2.
    Landahl S, Bengtsson C, Sigurdsson JA, Svanborg A, Svardsudd K. Age-related changes in blood pressure. Hypertension 1986;8:1044–1049.PubMedGoogle Scholar
  3. 3.
    Pan HY, Hoffman BB, Pershe RA, Blaschke TF. Decline in beta adrenergic receptor-mediated vascular relaxation with aging in man. J Pharmacol Exp Ther 1986;239:802–807.PubMedGoogle Scholar
  4. 4.
    Folkow B, Svanborg A. Physiology of cardiovascular aging. Physiol Rev 1993;73:725–764.PubMedGoogle Scholar
  5. 5.
    Falk RH. Etiology and complications of atrial fibrillation: insights from pathology studies. Am J Cardiol 1998;82: 10N–17N.PubMedCrossRefGoogle Scholar
  6. 6.
    Mackstaller LL, Alpert JS. Atrial fibrillation: a review of mechanism, etiology, and therapy. Clin Cardiol 1997;20: 640–650.PubMedGoogle Scholar
  7. 7.
    Lakatta EG. Age-related alterations in the cardiovascular response to adrenergic mediated stress. Fed Proc 1980; 39:3173–3177.PubMedGoogle Scholar
  8. 8.
    Rodeheffer RJ, Gerstenblith G, Becker LC, Fleg JL, Weisfeldt ML, Lakatta EG. Exercise cardiac output is maintained with advancing age in healthy human subjects: cardiac dilatation and increased stroke volume compensate for a diminished heart rate. Circulation 1984;69: 203–213.PubMedGoogle Scholar
  9. 9.
    Collins KJ, Exton-Smith AN, James MH, Oliver DJ. Functional changes in autonomic nervous responses with ageing. Age Ageing 1980;9:17–24.PubMedCrossRefGoogle Scholar
  10. 10.
    McGarry K, Laher M, Fitzgerald D, Horgan J, O’Brien E, O’Malley K. Baroreflex function in elderly hypertensives. Hypertension 1983;5:763–766.PubMedGoogle Scholar
  11. 11.
    Phillips PA, Hodsman GP, Johnston CI. Neuroendocrine mechanisms and cardiovascular homeostasis in the elderly. Cardiovasc Drugs Ther 1991;4(Suppl 6):1209–1213.PubMedCrossRefGoogle Scholar
  12. 12.
    Cleroux J, Giannattasio C, Bolla G, et al. Decreased cardiopulmonary reflexes with aging in normotensive humans. Am J Physiol 1989;257:H961–H968.PubMedGoogle Scholar
  13. 13.
    Rowe JW, Troen BR. Sympathetic nervous system and aging in man. Endocr Rev 1980;1:167–179.PubMedGoogle Scholar
  14. 14.
    Wahba WM. Influence of aging on lung function—clinical significance of changes from age twenty. Anesth Analg 1983;62:764–776.PubMedCrossRefGoogle Scholar
  15. 15.
    Zaugg M, Lucchinetti E. Respiratory function in the elderly. Anesthesiol Clin North Am 2000;18:47–58, vi.CrossRefGoogle Scholar
  16. 16.
    Fowler RW. Ageing and lung function. Age Ageing 1985; 14:209–215.PubMedCrossRefGoogle Scholar
  17. 17.
    Tolep K, Kelsen SG. Effect of aging on respiratory skeletal muscles. Clin Chest Med 1993;14:363–378.PubMedGoogle Scholar
  18. 18.
    Pontoppidan H, Geffin B, Lowenstein E. Acute respiratory failure in the adult. 1. N Engl J Med 1972;287:690–698.PubMedGoogle Scholar
  19. 19.
    Kitamura H, Sawa T, Ikezono E. Postoperative hypoxemia: the contribution of age to the maldistribution of ventilation. Anesthesiology 1972;36:244–252.PubMedCrossRefGoogle Scholar
  20. 20.
    Lynne-Davies P. Influence of age on the respiratory system. Geriatrics 1977;32:57–60.PubMedGoogle Scholar
  21. 21.
    Cerveri I, Zoia MC, Fanfulla F, et al. Reference values of arterial oxygen tension in the middle-aged and elderly. Am J Respir Crit Care Med 1995;152:934–941.PubMedGoogle Scholar
  22. 22.
    Kronenberg RS, Drage CW. Attenuation of the ventilatory and heart rate responses to hypoxia and hypercapnia with aging in normal men. J Clin Invest 1973;52:1812–1819.PubMedCrossRefGoogle Scholar
  23. 23.
    Aviv JE. Effects of aging on sensitivity of the pharyngeal and supraglottic areas. Am J Med 1997;103:74S–76S.PubMedCrossRefGoogle Scholar
  24. 24.
    Marik PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 2001;344:665–671.PubMedCrossRefGoogle Scholar
  25. 25.
    Arunasalam K, Davenport HT, Painter S, Jones JG. Ventilatory response to morphine in young and old subjects. Anaesthesia 1983;38:529–533.PubMedGoogle Scholar
  26. 26.
    Sari A, Miyauchi Y, Yamashita S, Yokota K, Ogasahara H, Yonei A. The magnitude of hypoxemia in elderly patients with fractures of the femoral neck. Anesth Analg 1986; 65:892–894.PubMedGoogle Scholar
  27. 27.
    Kronenberg RS, Drage CW, Ponto RA, Williams LE. The effect of age on the distribution of ventilation and perfusion in the lung. Am Rev Respir Dis 1973;108:576–586.PubMedGoogle Scholar
  28. 28.
    Clayer M, Bruckner J. Occult hypoxia after femoral neck fracture and elective hip surgery. Clin Orthop 2000: 265–271.Google Scholar
  29. 29.
    Moller JT, Jensen PF, Johannessen NW, Espersen K. Hypoxaemia is reduced by pulse oximetry monitoring in the operating theatre and in the recovery room. Br J Anaesth 1992;68:146–150.PubMedCrossRefGoogle Scholar
  30. 30.
    de Larminat V, Montravers P, Dureuil B, Desmonts JM. Alteration in swallowing reflex after extubation in intensive care unit patients. Crit Care Med 1995;23:486–490.PubMedCrossRefGoogle Scholar
  31. 31.
    Morris JC, McManus DQ. The neurology of aging: normal versus pathologic change. Geriatrics 1991;46:47–48, 51–54.PubMedGoogle Scholar
  32. 32.
    Creasey H, Rapoport SI. The aging human brain. Ann Neurol 1985;17:2–10.PubMedCrossRefGoogle Scholar
  33. 33.
    Morrison JH, Hof PR. Life and death of neurons in the aging brain. Science 1997;278:412–419.PubMedCrossRefGoogle Scholar
  34. 34.
    Severson JA. Neurotransmitter receptors and aging. J Am Geriatr Soc 1984;32:24–27.PubMedGoogle Scholar
  35. 35.
    Wong DF, Wagner HN Jr, Dannals RF, et al. Effects of age on dopamine and serotonin receptors measured by positron tomography in the living human brain. Science 1984;226:1393–1396.PubMedCrossRefGoogle Scholar
  36. 36.
    Muravchick S. Central nervous system. In: Geroanesthesia: Principles for Management of the Elderly Patient. St. Louis: Mosby-Year Book; 1997:78–113.Google Scholar
  37. 37.
    Peterson DD, Pack AI, Silage DA, Fishman AP. Effects of aging on ventilatory and occlusion pressure responses to hypoxia and hypercapnia. Am Rev Respir Dis 1981; 124:387–391.PubMedGoogle Scholar
  38. 38.
    Muravchick S. Peripheral and autonomic nervous system. In: Geroanesthesia: Principles for Management of the Elderly Patient. St. Louis: Mosby-Year Book; 1997: 114–148.Google Scholar
  39. 39.
    Gibson SJ, Helme RD. Age differences in pain perception and report: a review of physiological, psychological, laboratory and clinical studies. Pain Rev 1995;2:111–137.Google Scholar
  40. 40.
    Tucker MA, Andrew MF, Ogle SJ, Davison JG. Ageassociated change in pain threshold measured by transcutaneous neuronal electrical stimulation. Age Ageing 1989;18:241–246.PubMedCrossRefGoogle Scholar
  41. 41.
    Potvin AR, Syndulko K, Tourtellotte WW, Lemmon JA, Potvin JH. Human neurologic function and the aging process. J Am Geriatr Soc 1980;28:1–9.PubMedGoogle Scholar
  42. 42.
    Chakour MC, Gibson SJ, Bradbeer M, Helme RD. The effect of age on A delta-and C-fibre thermal pain perception. Pain 1996;64:143–152.PubMedCrossRefGoogle Scholar
  43. 43.
    Helme RD, Gibson SJ. Pain in the elderly. In: Jensen TS, Turner JA, Wiesenfeld-Hallin Z, eds. Proceedings of the 8th World Congress on Pain. Parkville, Australia: IASP Press; 1997:919–944.Google Scholar
  44. 44.
    Harkins SW. Geriatric pain. Pain perceptions in the old. Clin Geriatr Med 1996;12:435–459.PubMedGoogle Scholar
  45. 45.
    Harkins SW, Davis MD, Bush FM, Kasberger J. Suppression of first pain and slow temporal summation of second pain in relation to age. J Gerontol A Biol Sci Med Sci 1996; 51:M260–M265.PubMedGoogle Scholar
  46. 46.
    Ferrell BA. Pain management in elderly people. J Am Geriatr Soc 1991;39:64–73.PubMedGoogle Scholar
  47. 47.
    Anonymous. The management of chronic pain in older persons: AGS Panel on Chronic Pain in Older Persons. American Geriatrics Society. J Am Geriatr Soc 1998;46: 635–651.Google Scholar
  48. 48.
    Jones JS, Johnson K, McNinch M. Age as a risk factor for inadequate emergency department analgesia. Am J Emerg Med 1996;14:157–160.PubMedCrossRefGoogle Scholar
  49. 49.
    McLachlan MS. The ageing kidney. Lancet 1978;2:143–145.PubMedCrossRefGoogle Scholar
  50. 50.
    Anderson S, Brenner BM. The aging kidney: structure, function, mechanisms, and therapeutic implications. J Am Geriatr Soc 1987;35:590–593.PubMedGoogle Scholar
  51. 51.
    Epstein M. Aging and the kidney. J Am Soc Nephrol 1996;7:1106–1122.PubMedGoogle Scholar
  52. 52.
    Anderson S, Brenner BM. Effects of aging on the renal glomerulus. Am J Med 1986;80:435–442.PubMedCrossRefGoogle Scholar
  53. 53.
    Shannon RP, Minaker KL, Rowe JW. Aging and water balance in humans. Semin Nephrol 1984;4:346–353.Google Scholar
  54. 54.
    Miller M. Fluid and electrolyte balance in the elderly. Geriatrics 1987;42:65–76.PubMedGoogle Scholar
  55. 55.
    Phillips PA, Rolls BJ, Ledingham JG, et al. Reduced thirst after water deprivation in healthy elderly men. N Engl J Med 1984;311:753–759.PubMedGoogle Scholar
  56. 56.
    Rowe JW, Minaker KL, Sparrow D, Robertson GL. Agerelated failure of volume-pressure-mediated vasopressin release. J Clin Endocrinol Metab 1982;54:661–664.PubMedGoogle Scholar
  57. 57.
    Kliger AS. The role of the kidney in fluid, electrolyte, and acid-base disorders. Int Anesthesiol Clin 1984;22:65–82.PubMedCrossRefGoogle Scholar
  58. 58.
    Lamy PP, Wiser TH. Geriatric anesthesia. In: Katlic MR, ed. Pharmacotherapeutic Considerations in the Elderly Surgical Patient. Baltimore: Urban & Schwarzenberg; 1990:209–239.Google Scholar
  59. 59.
    Greenblatt DJ, Sellers EM, Shader RI. Drug therapy: drug disposition in old age. N Engl J Med 1982;306: 1081–1088.PubMedGoogle Scholar
  60. 60.
    Shafer SL. The pharmacology of anesthetic drugs in elderly patients. Anesthesiol Clin North Am 2000;18:1–29, v.CrossRefGoogle Scholar
  61. 61.
    Matteo RS, Ornstein E. Pharmacokinetics and pharmacodynamics of injected drugs in the elderly. Adv Anesth 1988;5:25–52.Google Scholar
  62. 62.
    Silverstein JH, Bloom HG, Cassel CK. New challenges in anesthesia: new practice opportunities. Anesthesiol Clin North Am 1999;17:453–465.CrossRefGoogle Scholar
  63. 63.
    Dundee JW, Robinson FP, McCollum JS, Patterson CC. Sensitivity to propofol in the elderly. Anaesthesia 1986; 41:482–485.PubMedCrossRefGoogle Scholar
  64. 64.
    Jacobs JR, Reves JG, Marty J, White WD, Bai SA, Smith LR. Aging increases pharmacodynamic sensitivity to the hypnotic effects of midazolam. Anesth Analg 1995;80: 143–148.PubMedCrossRefGoogle Scholar
  65. 65.
    Homer TD, Stanski DR. The effect of increasing age on thiopental disposition and anesthetic requirement. Anesthesiology 1985;62:714–724.PubMedCrossRefGoogle Scholar
  66. 66.
    Hurwitz N. Predisposing factors in adverse reactions to drugs. Br Med J 1969;1:536–539.PubMedGoogle Scholar
  67. 67.
    Hurwitz N, Wade OL. Intensive hospital monitoring of adverse reactions to drugs. Br Med J 1969;1:531–536.PubMedGoogle Scholar
  68. 68.
    Patterson C. Iatrogenic disease in late life. Clin Geriatr Med 1986;2:121–136.PubMedGoogle Scholar
  69. 69.
    Williamson J, Chopin JM. Adverse reactions to prescribed drugs in the elderly: a multicentre investigation. Age Ageing 1980;9:73–80.PubMedCrossRefGoogle Scholar
  70. 70.
    Muravchick S. The biology of aging and preoperative evaluation. In: Geroanesthesia: Principles for Management of the Elderly Patient. St. Louis: Mosby-Year Book; 1997: 1–34.Google Scholar
  71. 71.
    Thomas DR, Ritchie CS. Preoperative assessment of older adults. J Am Geriatr Soc 1995;43:811–821.PubMedGoogle Scholar
  72. 72.
    Vaz FG, Seymour DG. A prospective study of elderly general surgical patients: I. Preoperative medical problems. Age Ageing 1989;18:309–315.PubMedCrossRefGoogle Scholar
  73. 73.
    Schneider JR, Droste JS, Schindler N, Golan JF. Carotid endarterectomy in octogenarians: comparison with patient characteristics and outcomes in younger patients. J Vasc Surg 2000;31:927–935.PubMedCrossRefGoogle Scholar
  74. 74.
    Hoballah JJ, Nazzal MM, Jacobovicz C, Sharp WJ, Kresowik TF, Corson JD. Entering the ninth decade is not a contraindication for carotid endarterectomy. Angiology 1998;49:275–278.PubMedGoogle Scholar
  75. 75.
    Hosking MP, Warner MA, Lobdell CM, Offord KP, Melton LJd. Outcomes of surgery in patients 90 years of age and older [see comments]. JAMA 1989;261:1909–1915.PubMedCrossRefGoogle Scholar
  76. 76.
    Warner MA, Saletel RA, Schroeder DR, Warner DO, Offord KP, Gray DT. Outcomes of anesthesia and surgery in people 100 years of age and older. J Am Geriatr Soc 1998;46:988–993.PubMedGoogle Scholar
  77. 77.
    Laskin RS. Total knee replacement in patients older than 85 years. Clin Orthop 1999:43–49.Google Scholar
  78. 78.
    Tiret L, Desmonts JM, Hatton F, Vourc’h G. Complications associated with anaesthesia—a prospective survey in France. Can Anaesth Soc J 1986;33:336–344.PubMedGoogle Scholar
  79. 79.
    Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery. Circulation 1996;93: 1278–1317.PubMedGoogle Scholar
  80. 80.
    Goldman L. Cardiac risks and complications of noncardiac surgery. Ann Intern Med 1983;98:504–513.PubMedGoogle Scholar
  81. 81.
    Liu LL, Leung JM. Predicting adverse postoperative outcomes in patients aged 80 years or older. J Am Geriatr Soc 2000;48:405–412.PubMedGoogle Scholar
  82. 82.
    Arvidsson S, Ouchterlony J, Sjostedt L, Svardsudd K. Predicting postoperative adverse events. Clinical efficiency of four general classification systems. The project perioperative risk. Acta Anaesthesiol Scand 1996;40:783–791.PubMedGoogle Scholar
  83. 83.
    Detsky AS, Abrams HB, Forbath N, Scott JG, Hilliard JR. Cardiac assessment for patients undergoing noncardiac surgery. A multifactorial clinical risk index. Arch Intern Med 1986;146:2131–2134.PubMedCrossRefGoogle Scholar
  84. 84.
    Pedersen T, Eliasen K, Henriksen E. A prospective study of risk factors and cardiopulmonary complications associated with anaesthesia and surgery: risk indicators of cardiopulmonary morbidity. Acta Anaesthesiol Scand 1990;34:144–155.PubMedGoogle Scholar
  85. 85.
    Pedersen T, Eliasen K, Henriksen E. A prospective study of mortality associated with anaesthesia and surgery: risk indicators of mortality in hospital. Acta Anaesthesiol Scand 1990;34:176–182.PubMedGoogle Scholar
  86. 86.
    Browner WS, Li J, Mangano DT. In-hospital and long-term mortality in male veterans following noncardiac surgery. The Study of Perioperative Ischemia Research Group. JAMA 1992;268:228–232.PubMedCrossRefGoogle Scholar
  87. 87.
    Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg 1995;180:519–531.PubMedGoogle Scholar
  88. 88.
    Arvidsson S, Ouchterlony J, Nilsson S, Sjostedt L, Svardsudd K. The Gothenburg study of perioperative risk. I. Preoperative findings, postoperative complications. Acta Anaesthesiol Scand 1994;38:679–690.PubMedCrossRefGoogle Scholar
  89. 89.
    Mohr DN. Estimation of surgical risk in the elderly: a correlative review. J Am Geriatr Soc 1983;31:99–102.PubMedGoogle Scholar
  90. 90.
    Cheng KW, Wang CH, Ho RT, Jawan B, Lee JH. Outcome of surgery and anesthesia in patients 80 years of age and older. Acta Anaesthesiol Sin 1994;32:37–43.PubMedGoogle Scholar
  91. 91.
    Cohen MM, Duncan PG, Tate RB. Does anesthesia contribute to operative mortality? JAMA 1988;260:2859–2863.PubMedCrossRefGoogle Scholar
  92. 92.
    Cohen MM, Duncan PG. Physical status score and trends in anesthetic complications. J Clin Epidemiol 1988;41: 83–90.PubMedCrossRefGoogle Scholar
  93. 93.
    Goldman L, Hashimoto B, Cook EF, Loscalzo A. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation 1981;64:1227–1234.PubMedGoogle Scholar
  94. 94.
    Lawton MP, Brody EM. Assessment of older people: selfmaintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186.PubMedGoogle Scholar
  95. 95.
    Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). Med Care 1992;30:473–483.PubMedCrossRefGoogle Scholar
  96. 96.
    Moy ML, Ingenito EP, Mentzer SJ, Evans RB, Reilly JJ Jr. Health-related quality of life improves following pulmonary rehabilitation and lung volume reduction surgery. Chest 1999;115:383–389.PubMedCrossRefGoogle Scholar
  97. 97.
    Mangione CM, Goldman L, Orav EJ, et al. Health-related quality of life after elective surgery: measurement of longitudinal changes. J Gen Intern Med 1997;12:686–697.PubMedCrossRefGoogle Scholar
  98. 98.
    Hannan EL, Magaziner J, Wang JJ, et al. Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA 2001;285:2736–2742.PubMedCrossRefGoogle Scholar
  99. 99.
    Tammela T, Kontturi M, Lukkarinen O. Postoperative urinary retention. I. Incidence and predisposing factors. Scand J Urol Nephrol 1986;20:197–201.PubMedCrossRefGoogle Scholar
  100. 100.
    Duits AA, Boeke S, Taams MA, Passchier J, Erdman RA. Prediction of quality of life after coronary artery bypass graft surgery: a review and evaluation of multiple, recent studies. Psychosom Med 1997;59:257–268.PubMedGoogle Scholar
  101. 101.
    Keene JS, Anderson CA. Hip fractures in the elderly. Discharge predictions with a functional rating scale. JAMA 1982;248:564–567.PubMedCrossRefGoogle Scholar
  102. 102.
    McCartney JR, Palmateer LM. Assessment of cognitive deficit in geriatric patients. A study of physician behavior. J Am Geriatr Soc 1985;33:467–471.PubMedGoogle Scholar
  103. 103.
    Inouye SK, Peduzzi PN, Robison JT, Hughes JS, Horwitz RI, Concato J. Importance of functional measures in predicting mortality among older hospitalized patients. JAMA 1998;279:1187–1193.PubMedCrossRefGoogle Scholar
  104. 104.
    Raja SN, Haythornthwaite JA. Anesthetic management of the elderly: measuring function beyond the immediate perioperative horizon. Anesthesiology 1999;91:909–911.PubMedCrossRefGoogle Scholar
  105. 105.
    Heyland DK, Guyatt G, Cook DJ, et al. Frequency and methodologic rigor of quality-of-life assessments in the critical care literature. Crit Care Med 1998;26:591–598.PubMedCrossRefGoogle Scholar
  106. 106.
    Holmes J, House A. Psychiatric illness predicts poor outcome after surgery for hip fracture: a prospective cohort study. Psychol Med 2000;30:921–929.PubMedCrossRefGoogle Scholar
  107. 107.
    Dolan MM, Hawkes WG, Zimmerman SI, et al. Delirium on hospital admission in aged hip fracture patients: prediction of mortality and 2-year functional outcomes. J Gerontol A Biol Sci Med Sci 2000;55:M527–M534.PubMedGoogle Scholar
  108. 108.
    Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med 1999;106: 565–573.PubMedCrossRefGoogle Scholar
  109. 109.
    Millar K, Asbury AJ, Murray GD. Pre-existing cognitive impairment as a factor influencing outcome after cardiac surgery. Br J Anaesth 2001;86:63–67.PubMedCrossRefGoogle Scholar
  110. 110.
    Dyer CB, Ashton CM, Teasdale TA. Postoperative delirium. A review of 80 primary data-collection studies. Arch Intern Med 1995;155:461–465.PubMedCrossRefGoogle Scholar
  111. 111.
    Ni Chonchubhair A, Valacio R, Kelly J, O’Keefe S. Use of the abbreviated mental test to detect postoperative delirium in elderly people. Br J Anaesth 1995;75:481–482.PubMedGoogle Scholar
  112. 112.
    Kaneko T, Takahashi S, Naka T, Hirooka Y, Inoue Y, Kaibara N. Postoperative delirium following gastrointestinal surgery in elderly patients. Surg Today 1997;27: 107–111.PubMedCrossRefGoogle Scholar
  113. 113.
    Gustafson Y, Berggren D, Brannstrom B, et al. Acute confusional states in elderly patients treated for femoral neck fracture. J Am Geriatr Soc 1988;36:525–530.PubMedGoogle Scholar
  114. 114.
    McDowell I, Kristjansson B, Hill GB, Hebert R. Community screening for dementia: the Mini Mental State Exam (MMSE) and Modified Mini-Mental State Exam (3MS) compared. J Clin Epidemiol 1997;50:377–383.PubMedCrossRefGoogle Scholar
  115. 115.
    Folstein MF, Folstein SE, McHugh PR. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12: 189–198.PubMedCrossRefGoogle Scholar
  116. 116.
    Berggren D, Gustafson Y, Eriksson B, et al. Postoperative confusion after anesthesia in elderly patients with femoral neck fractures. Anesth Analg 1987;66:497–504.PubMedCrossRefGoogle Scholar
  117. 117.
    Williams-Russo P, Urquhart BL, Sharrock NE, Charlson ME. Post-operative delirium: predictors and prognosis in elderly orthopedic patients [see comments]. J Am Geriatr Soc 1992;40:759–767.PubMedGoogle Scholar
  118. 118.
    de Graeff A, de Leeuw JR, Ros WJ, Hordijk GJ, Blijham GH, Winnubst JA. Pretreatment factors predicting quality of life after treatment for head and neck cancer. Head Neck 2000;22:398–407.PubMedCrossRefGoogle Scholar
  119. 119.
    Lyness JM, Noel TK, Cox C, King DA, Conwell Y, Caine ED. Screening for depression in elderly primary care patients. A comparison of the Center for Epidemiologic Studies-Depression Scale and the Geriatric Depression Scale. Arch Intern Med 1997;157:449–454.PubMedCrossRefGoogle Scholar
  120. 120.
    Roca R. Psychosocial aspects of surgical care in the elderly patient. Surg Clin North Am 1994;74:223–243.PubMedGoogle Scholar
  121. 121.
    Bradley EH, Bogardus ST Jr, van Doorn C, Williams CS, Cherlin E, Inouye SK. Goals in geriatric assessment: are we measuring the right outcomes? Gerontologist 2000; 40:191–196.PubMedGoogle Scholar
  122. 122.
    Heijmeriks JA, Pourrier S, Dassen P, Prenger K, Wellens HJ. Comparison of quality of life after coronary and/or valvular cardiac surgery in patients > or =75 years of age with younger patients. Am J Cardiol 1999;83:1129–1132, A9.PubMedCrossRefGoogle Scholar
  123. 123.
    Katz S. Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc 1983;31:721–727.PubMedGoogle Scholar
  124. 124.
    Turnbull JM, Buck C. The value of preoperative screening investigations in otherwise healthy individuals. Arch Intern Med 1987;147:1101–1105.PubMedCrossRefGoogle Scholar
  125. 125.
    Perez A, Planell J, Bacardaz C, et al. Value of routine preoperative tests: a multicentre study in four general hospitals. Br J Anaesth 1995;74:250–256.PubMedCrossRefGoogle Scholar
  126. 126.
    Kaplan EB, Sheiner LB, Boeckmann AJ, et al. The usefulness of preoperative laboratory screening. JAMA 1985; 253:3576–3581.PubMedCrossRefGoogle Scholar
  127. 127.
    Narr BJ, Warner ME, Schroeder DR, Warner MA. Outcomes of patients with no laboratory assessment before anesthesia and a surgical procedure. Mayo Clin Proc 1997; 72:505–509.PubMedCrossRefGoogle Scholar
  128. 128.
    Seymour DG, Pringle R, Shaw JW. The role of the routine pre-operative chest X-ray in the elderly general surgical patient. Postgrad Med J 1982;58:741–745.PubMedCrossRefGoogle Scholar
  129. 129.
    Seymour DG, Pringle R, MacLennan WJ. The role of the routine pre-operative electrocardiogram in the elderly surgical patient. Age Ageing 1983;12:97–104.PubMedCrossRefGoogle Scholar
  130. 130.
    Sewell JM, Spooner LL, Dixon AK, Rubenstein D. Screening investigations in the elderly. Age Ageing 1981; 10:165–168.PubMedCrossRefGoogle Scholar
  131. 131.
    Sanders DP, McKinney FW, Harris WH. Clinical evaluation and cost effectiveness of preoperative laboratory assessment on patients undergoing total hip arthroplasty. Orthopedics 1989;12:1449–1453.PubMedGoogle Scholar
  132. 132.
    Grimes CJ, Younathan MT, Lee WC. The effect of preoperative total parenteral nutrition on surgery outcomes. J Am Diet Assoc 1987;87:1202–1206.PubMedGoogle Scholar
  133. 133.
    Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg 1999;134:36–42.PubMedCrossRefGoogle Scholar
  134. 134.
    Baker JP, Detsky AS, Wesson DE, et al. Nutritional assessment: a comparison of clinical judgement and objective measurements. N Engl J Med 1982;306:969–972.PubMedGoogle Scholar
  135. 135.
    Covinsky KE, Martin GE, Beyth RJ, Justice AC, Sehgal AR, Landefeld CS. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients. J Am Geriatr Soc 1999; 47:532–538.PubMedGoogle Scholar
  136. 136.
    Mazolewski P, Turner JF, Baker M, Kurtz T, Little AG. The impact of nutritional status on the outcome of lung volume reduction surgery: a prospective study. Chest 1999;116: 693–696.PubMedCrossRefGoogle Scholar
  137. 137.
    Cohendy R, Gros T, Arnaud-Battandier F, Tran G, Plaze JM, Eledjam J. Preoperative nutritional evaluation of elderly patients: the Mini Nutritional Assessment as a practical tool. Clin Nutr 1999;18:345–348.PubMedCrossRefGoogle Scholar
  138. 138.
    McClave SA, Snider HL, Spain DA. Preoperative issues in clinical nutrition. Chest 1999;115:64S–70S.PubMedCrossRefGoogle Scholar
  139. 139.
    Moore AA, Siu AL. Screening for common problems in ambulatory elderly: clinical confirmation of a screening instrument. Am J Med 1996;100:438–443.PubMedCrossRefGoogle Scholar
  140. 140.
    Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Med 2000;342:168–175.PubMedCrossRefGoogle Scholar
  141. 141.
    Dzankic S, Pastor D, Gonzalez C, Leung JM. The prevalence and predictive value of abnormal preoperative laboratory tests in elderly surgical patients. Anesth Analg 2001;93:301–308.PubMedCrossRefGoogle Scholar
  142. 142.
    Berlauk JF, Abrams JH, Gilmour IJ, O’Connor SR, Knighton DR, Cerra FB. Preoperative optimization of cardiovascular hemodynamics improves outcome in peripheral vascular surgery. A prospective, randomized clinical trial. Ann Surg 1991;214:289–297;discussion 298–299.PubMedCrossRefGoogle Scholar
  143. 143.
    Leppo JA. Preoperative cardiac risk assessment for noncardiac surgery. Am J Cardiol 1995;75:42D–51D.PubMedCrossRefGoogle Scholar
  144. 144.
    Roubenoff R, Roubenoff RA, Preto J, Balke CW. Malnutrition among hospitalized patients. A problem of physician awareness. Arch Intern Med 1987;147:1462–1465.PubMedCrossRefGoogle Scholar
  145. 145.
    Del Guercio LR, Cohn JD. Monitoring operative risk in the elderly. JAMA 1980;243:1350–1355.PubMedCrossRefGoogle Scholar
  146. 146.
    Smith MS, Muir H, Hall R. Perioperative management of drug therapy, clinical considerations. Drugs 1996;51: 238–259.PubMedCrossRefGoogle Scholar
  147. 147.
    Zaugg M, Tagliente T, Lucchinetti E, et al. Beneficial effects from beta-adrenergic blockade in elderly patients undergoing noncardiac surgery. Anesthesiology 1999;91: 1674–1686.PubMedCrossRefGoogle Scholar
  148. 148.
    Yeager RA, Moneta GL, Edwards JM, Taylor LMJ, McConnell DB, Porter JM. Reducing perioperative myocardial infarction following vascular surgery: the potential role of beta-blockade. Arch Surg 1995;130:869–873.PubMedGoogle Scholar
  149. 149.
    Bisson A, Stern M, Caubarrere I. Preparation of high-risk patients for major thoracic surgery. Chest Surg Clin North Am 1998;8:541–555, viii.Google Scholar
  150. 150.
    Debigare R, Maltais F, Whittom F, Deslauriers J, LeBlanc P. Feasibility and efficacy of home exercise training before lung volume reduction. J Cardiopulm Rehabil 1999;19: 235–241.PubMedCrossRefGoogle Scholar
  151. 151.
    Arthur HM, Daniels C, McKelvie R, Hirsh J, Rush B. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery. A randomized, controlled trial. Ann Intern Med 2000;133:253–262.PubMedGoogle Scholar
  152. 152.
    Fisher DA, Trimble S, Clapp B, Dorsett K. Effect of a patient management system on outcomes of total hip and knee arthroplasty. Clin Orthop 1997:155–160.Google Scholar
  153. 153.
    Roy RC. Choosing general versus regional anesthesia for the elderly. Anesthesiol Clin North Am 2000;18:91–104, vii.CrossRefGoogle Scholar
  154. 154.
    McLaren AD, Stockwell MC, Reid VT. Anaesthetic techniques for surgical correction of fractured neck of femur. A comparative study of spinal and general anaesthesia in the elderly. Anaesthesia 1978;33:10–14.PubMedCrossRefGoogle Scholar
  155. 155.
    Hole A, Terjesen T, Breivik H. Epidural versus general anaesthesia for total hip arthroplasty in elderly patients. Acta Anaesthesiol Scand 1980;24:279–287.PubMedGoogle Scholar
  156. 156.
    Nielson WR, Gelb AW, Casey JE, Penny FJ, Merchant RN, Manninen PH. Long-term cognitive and social sequelae of general versus regional anesthesia during arthroplasty in the elderly. Anesthesiology 1990;73:1103–1109.PubMedCrossRefGoogle Scholar
  157. 157.
    Davis FM, Woolner DF, Frampton C, et al. Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly. Br J Anaesth 1987;59:1080–1088.PubMedCrossRefGoogle Scholar
  158. 158.
    McKenzie PJ, Wishart HY, Dewar KM, Gray I, Smith G. Comparison of the effects of spinal anaesthesia and general anaesthesia on postoperative oxygenation and perioperative mortality. Br J Anaesth 1980;52:49–54.PubMedCrossRefGoogle Scholar
  159. 159.
    McKenzie PJ, Wishart HY, Gray I, Smith G. Effects of anaesthetic technique on deep vein thrombosis. A comparison of subarachnoid and general anaesthesia. Br J Anaesth 1985;57:853–857.PubMedCrossRefGoogle Scholar
  160. 160.
    Hendolin H, Mattila MA, Poikolainen E. The effect of lumbar epidural analgesia on the development of deep vein thrombosis of the legs after open prostatectomy. Acta Chir Scand 1981;147:425–429.PubMedGoogle Scholar
  161. 161.
    White PF. Anesthetic techniques for the elderly outpatient. Int Anesthesiol Clin 1988;26:105–111.PubMedGoogle Scholar
  162. 162.
    Valentin N, Lomholt B, Jensen JS, Hejgaard N, Kreiner S. Spinal or general anaesthesia for surgery of the fractured hip? A prospective study of mortality in 578 patients. Br J Anaesth 1986;58:284–291.PubMedCrossRefGoogle Scholar
  163. 163.
    Sorenson RM, Pace NL. Anesthetic techniques during surgical repair of femoral neck fractures. A meta-analysis. Anesthesiology 1992;77:1095–1104.PubMedCrossRefGoogle Scholar
  164. 164.
    Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. Br J Anaesth 2000;84:450–455.PubMedGoogle Scholar
  165. 165.
    Gilbert TB, Hawkes WG, Hebel JR, et al. Spinal anesthesia versus general anesthesia for hip fracture repair: a longitudinal observation of 741 elderly patients during 2-year follow-up. Am J Orthop 2000;29:25–35.PubMedCrossRefGoogle Scholar
  166. 166.
    Sutcliffe AJ, Parker M. Mortality after spinal and general anaesthesia for surgical fixation of hip fractures. Anaesthesia 1994;49:237–240.PubMedGoogle Scholar
  167. 167.
    O’Hara DA, Duff A, Berlin JA, et al. The effect of anesthetic technique on postoperative outcomes in hip fracture repair. Anesthesiology 2000;92:947–957.PubMedCrossRefGoogle Scholar
  168. 168.
    Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493.PubMedCrossRefGoogle Scholar
  169. 169.
    Riis J, Lomholt B, Haxholdt O, et al. Immediate and longterm mental recovery from general versus epidural anesthesia in elderly patients. Acta Anaesthesiol Scand 1983; 27:44–49.PubMedGoogle Scholar
  170. 170.
    Bigler D, Adelhoj B, Petring OU, Pederson NO, Busch P, Kalhke P. Mental function and morbidity after acute hip surgery during spinal and general anaesthesia. Anaesthesia 1985;40:672–676.PubMedCrossRefGoogle Scholar
  171. 171.
    Ghoneim MM, Hinrichs JV, O’Hara MW, et al. Comparison of psychologic and cognitive functions after general or regional anesthesia. Anesthesiology 1988;69:507–515.PubMedCrossRefGoogle Scholar
  172. 172.
    Norris EJ, Beattie C, Perler BA, et al. Double-masked randomized trial comparing alternate combinations of intraoperative anesthesia and postoperative analgesia in abdominal aortic surgery. Anesthesiology 2001;95:1054–1067.PubMedCrossRefGoogle Scholar
  173. 173.
    Yeager MP, Glass DD, Neff RK, Brinck-Johnsen T. Epidural anesthesia and analgesia in high-risk surgical patients. Anesthesiology 1987;66:729–736.PubMedCrossRefGoogle Scholar
  174. 174.
    Chung F, Meier R, Lautenschlager E, Carmichael FJ, Chung A. General or spinal anesthesia: which is better in the elderly? Anesthesiology 1987;67:422–427.PubMedCrossRefGoogle Scholar
  175. 175.
    Asbjorn J, Jakobsen BW, Pilegaard HK, Blom L, Ostergaard A, Brandt MR. Mental function in elderly men after surgery during epidural analgesia. Acta Anaesthesiol Scand 1989;33:369–373.PubMedGoogle Scholar
  176. 176.
    Edwards ND, Callaghan LC, White T, Reilly CS. Perioperative myocardial ischaemia in patients undergoing transurethral surgery: a pilot study comparing general with spinal anaesthesia. Br J Anaesth 1995;74:368–372.PubMedCrossRefGoogle Scholar
  177. 177.
    Bode RH, Lewis KP, Zarich SW, et al. Cardiac outcome after peripheral vascular surgery. Comparison of general and regional anesthesia. Anesthesiology 1996;84:3–13.PubMedCrossRefGoogle Scholar
  178. 178.
    Christopherson R, Beattie C, Frank SM, et al. Perioperative morbidity in patients randomized to epidural or general anesthesia for lower extremity vascular surgery. Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology 1993;79:422–434.PubMedCrossRefGoogle Scholar
  179. 179.
    Corson JD, Chang BB, Shah DM, Leather RP, DeLeo BM, Karmody AM. The influence of anesthetic choice on carotid endarterectomy outcome. Arch Surg 1987;122: 807–812.PubMedGoogle Scholar
  180. 180.
    Papavasiliou AK, Magnadottir HB, Gonda T, Franz D, Harbaugh RE. Clinical outcomes after carotid endarterectomy: comparison of the use of regional and general anesthetics. J Neurosurg 2000;92:291–296.PubMedGoogle Scholar
  181. 181.
    Fiorani P, Sbarigia E, Speziale F, et al. General anaesthesia versus cervical block and perioperative complications in carotid artery surgery. Eur J Vasc Endovasc Surg 1997; 13:37–42.PubMedCrossRefGoogle Scholar
  182. 182.
    Bowyer MW, Zierold D, Loftus JP, Egan JC, Inglis KJ, Halow KD. Carotid endarterectomy: a comparison of regional versus general anesthesia in 500 operations. Ann Vasc Surg 2000;14:145–151.PubMedCrossRefGoogle Scholar
  183. 183.
    Ferguson GG, Eliasziw M, Barr HW, et al. The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients [see comments]. Stroke 1999;30:1751–1758.PubMedGoogle Scholar
  184. 184.
    Slogoff S, Reul GJ, Keats AS, et al. Role of perfusion pressure and flow in major organ dysfunction after cardiopulmonary bypass. Ann Thorac Surg 1990;50:911–918.PubMedGoogle Scholar
  185. 185.
    Wong BI, McLean RF, Naylor CD, et al. Centralnervous-system dysfunction after warm or hypothermic cardiopulmonary bypass. Lancet 1992;339:1383–1384.PubMedCrossRefGoogle Scholar
  186. 186.
    Gold JP, Charlson ME, Williams-Russo P, et al. Improvement of outcomes after coronary artery bypass. A randomized trial comparing intraoperative high versus low mean arterial pressure. J Thorac Cardiovasc Surg 1995;110: 1302–1311; discussion 1311–1314.PubMedCrossRefGoogle Scholar
  187. 187.
    Roach GW, Kanchuger M, Mangano CM, et al. Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. N Engl J Med 1996;335:1857–1863.PubMedCrossRefGoogle Scholar
  188. 188.
    Cook DJ. Neurologic effects. In: Gravlee GP, Davis RF, Kurusz M, Utley JR, eds. Cardiopulmonary Bypass: Principles and Practice. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2000:403–431.Google Scholar
  189. 189.
    Frank SM, Beattie C, Christopherson R, et al. Unintentional hypothermia is associated with postoperative myocardial ischemia. The Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology 1993;78: 468–476.PubMedCrossRefGoogle Scholar
  190. 190.
    Frank SM, El-Rahmany HK, Cattaneo CG, Barnes RA. Predictors of hypothermia during spinal anesthesia. Anesthesiology 2000;92:1330–1334.PubMedCrossRefGoogle Scholar
  191. 191.
    Frank SM, Fleisher LA, Breslow MJ, et al. Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial. JAMA 1997;277:1127–1134.PubMedCrossRefGoogle Scholar
  192. 192.
    Frank SM, Fleisher LA, Olson KF, et al. Multivariate determinants of early postoperative oxygen consumption in elderly patients. Effects of shivering, body temperature, and gender. Anesthesiology 1995;83:241–249.PubMedCrossRefGoogle Scholar
  193. 193.
    Frank SM, Higgins MS, Breslow MJ, et al. The catecholamine, cortisol, and hemodynamic responses to mild perioperative hypothermia. A randomized clinical trial. Anesthesiology 1995;82:83–93.PubMedCrossRefGoogle Scholar
  194. 194.
    Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med 1996;335:1713–1720.PubMedCrossRefGoogle Scholar
  195. 195.
    Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med 1999;341:1789–1794.PubMedCrossRefGoogle Scholar
  196. 196.
    Nishina K, Mikawa K, Uesugi T, et al. Efficacy of clonidine for prevention of perioperative myocardial ischemia: a critical appraisal and meta-analysis of the literature. Anesthesiology 2002;96:323–329.PubMedCrossRefGoogle Scholar
  197. 197.
    van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med 2001;345:1359–1367.PubMedCrossRefGoogle Scholar
  198. 198.
    Cohen MM, Duncan PG, Tweed WA, et al. The Canadian four-centre study of anaesthetic outcomes: I. Description of methods and populations. Can J Anaesth 1992;39: 420–429.PubMedGoogle Scholar
  199. 199.
    Rao TL, Jacobs KH, El-Etr AA. Reinfarction following anesthesia in patients with myocardial infarction. Anesthesiology 1983;59:499–505.PubMedCrossRefGoogle Scholar
  200. 200.
    O’Keeffe ST, Ni Chonchubhair A. Postoperative delirium in the elderly. Br J Anaesth 1994;73:673–687.PubMedCrossRefGoogle Scholar
  201. 201.
    Seymour DG, Vaz FG. A prospective study of elderly general surgical patients: II. Post-operative complications. Age Ageing 1989;18:316–326.PubMedCrossRefGoogle Scholar
  202. 202.
    Moller JT, Johannessen NW, Espersen K, et al. Randomized evaluation of pulse oximetry in 20,802 patients: II. Perioperative events and postoperative complications. Anesthesiology 1993;78:445–453.PubMedGoogle Scholar
  203. 203.
    Moller JT, Svennild I, Johannessen NW, et al. Perioperative monitoring with pulse oximetry and late postoperative cognitive dysfunction. Br J Anaesth 1993;71:340–347.PubMedCrossRefGoogle Scholar
  204. 204.
    Pontoppidan H, Beecher HK. Progressive loss of protective reflexes in the airway with the advance of age. JAMA 1960;174:2209–2213.PubMedGoogle Scholar
  205. 205.
    Pedersen T, Viby-Mogensen J, Ringsted C. Anaesthetic practice and postoperative pulmonary complications. Acta Anaesthesiol Scand 1992;36:812–818.PubMedGoogle Scholar
  206. 206.
    Bailey PL, Pace NL, Ashburn MA, Moll JW, East KA, Stanley TH. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl. Anesthesiology 1990;73: 826–830.PubMedCrossRefGoogle Scholar
  207. 207.
    Hogue CW Jr, Lappas GD, Creswell LL, et al. Swallowing dysfunction after cardiac operations. Associated adverse outcomes and risk factors including intraoperative transesophageal echocardiography. J Thorac Cardiovasc Surg 1995;110:517–522.PubMedCrossRefGoogle Scholar
  208. 208.
    Mitchell CK, Smoger SH, Pfeifer MP, et al. Multivariate analysis of factors associated with postoperative pulmonary complications following general elective surgery. Arch Surg 1998;133:194–198.PubMedCrossRefGoogle Scholar
  209. 209.
    Warner MA, Warner ME, Weber JG. Clinical significance of pulmonary aspiration during the perioperative period. Anesthesiology 1993;78:56–62.PubMedCrossRefGoogle Scholar
  210. 210.
    Roberts JR, Shyr Y, Christian KR, Drinkwater D, Merrill W. Preemptive gastrointestinal tract management reduces aspiration and respiratory failure after thoracic operations. J Thorac Cardiovasc Surg 2000;119:449–452.PubMedCrossRefGoogle Scholar
  211. 211.
    Breslow MJ, Parker SD, Frank SM, et al. Determinants of catecholamine and cortisol responses to lower extremity revascularization. The PIRAT Study Group. Anesthesiology 1993;79:1202–1209.PubMedCrossRefGoogle Scholar
  212. 212.
    Rem J, Nielsen OS, Brandt MR, Kehlet H. Release mechanisms of postoperative changes in various acute phase proteins and immunoglobulins. Acta Chir Scand Suppl 1980;502:51–56.PubMedGoogle Scholar
  213. 213.
    Kilickan L, Toker K. The effects of preemptive intravenous versus preemptive epidural morphine on postoperative analgesia and surgical stress response after orthopaedic procedures. Minerva Anestesiol 2000;66:649–655.PubMedGoogle Scholar
  214. 214.
    Schulze S, Schierbeck J, Sparso BH, Bisgaard M, Kehlet H. Influence of neural blockade and indomethacin on leucocyte, temperature, and acute-phase protein response to surgery. Acta Chir Scand 1987;153:255–259.PubMedGoogle Scholar
  215. 215.
    Klasen JA, Opitz SA, Melzer C, Thiel A, Hempelmann G. Intraarticular, epidural, and intravenous analgesia after total knee arthroplasty. Acta Anaesthesiol Scand 1999;43: 1021–1026.PubMedCrossRefGoogle Scholar
  216. 216.
    Schulze S, Sommer P, Bigler D, et al. Effect of combined prednisolone, epidural analgesia, and indomethacin on the systemic response after colonic surgery. Arch Surg 1992; 127:325–331.PubMedGoogle Scholar
  217. 217.
    Rem J, Brandt MR, Kehlet H. Prevention of postoperative lymphopenia and granulocytosis by epidural analgesia. Lancet 1980;1:283–284.PubMedCrossRefGoogle Scholar
  218. 218.
    Hjortso NC, Andersen T, Frosig F, Neumann P, Rogon E, Kehlet H. Failure of epidural analgesia to modify postoperative depression of delayed hypersensitivity. Acta Anaesthesiol Scand 1984;28:128–131.PubMedGoogle Scholar
  219. 219.
    Rutberg H, Hakanson E, Anderberg B, Jorfeldt L, Martensson J, Schildt B. Effects of the extradural administration of morphine, or bupivacaine, on the endocrine response to upper abdominal surgery. Br J Anaesth 1984; 56:233–237.PubMedCrossRefGoogle Scholar
  220. 220.
    Liu S, Carpenter RL, Neal JM. Epidural anesthesia and analgesia. Their role in postoperative outcome. Anesthesiology 1995;82:1474–1506.PubMedCrossRefGoogle Scholar
  221. 221.
    Tuman KJ, McCarthy RJ, March RJ, DeLaria GA, Patel RV, Ivankovich AD. Effects of epidural anesthesia and analgesia on coagulation and outcome after major vascular surgery. Anesth Analg 1991;73:696–704.PubMedCrossRefGoogle Scholar
  222. 222.
    Giesecke K, Klingstedt C, Ljungqvist O, Hagenfeldt L. The modifying influence of anaesthesia on postoperative protein catabolism. Br J Anaesth 1994;72:697–699.PubMedCrossRefGoogle Scholar
  223. 223.
    Heindorff H, Schulze S, Mogensen T, Almdal T, Kehlet H, Vilstrup H. Hormonal and neural blockade prevents the postoperative increase in amino acid clearance and urea synthesis. Surgery 1992;111:543–550.PubMedGoogle Scholar
  224. 224.
    Carli F, Halliday D. Continuous epidural blockade arrests the postoperative decrease in muscle protein fractional synthetic rate in surgical patients. Anesthesiology 1997; 86:1033–1040.PubMedCrossRefGoogle Scholar
  225. 225.
    Wasylak TJ, Abbott FV, English MJ, Jeans ME. Reduction of postoperative morbidity following patient-controlled morphine. Can J Anaesth 1990;37:726–731.PubMedGoogle Scholar
  226. 226.
    Petros JG, Alameddine F, Testa E, Rimm EB, Robillard RJ. Patient-controlled analgesia and postoperative urinary retention after hysterectomy for benign disease. J Am Coll Surg 1994;179:663–667.PubMedGoogle Scholar
  227. 227.
    Petros JG, Mallen JK, Howe K, Rimm EB, Robillard RJ. Patient-controlled analgesia and postoperative urinary retention after open appendectomy. Surg Gynecol Obstet 1993;177:172–175.PubMedGoogle Scholar
  228. 228.
    Carpenter RL, Abram SE, Bromage PR, Rauck RL. Consensus statement on acute pain management. Reg Anesth 1996;21:152–156.PubMedGoogle Scholar
  229. 229.
    Carpenter RL. Gastrointestinal benefits of regional anesthesia/analgesia. Reg Anesth 1996;21:13–17.PubMedGoogle Scholar
  230. 230.
    Kumar A, Bose S, Bhattacharya A, Tandon OP, Kundra P. Oral clonidine premedication for elderly patients undergoing intraocular surgery. Acta Anaesthesiol Scand 1992; 36:159–164.PubMedGoogle Scholar
  231. 231.
    Singelyn FJ, Gouverneur JM. Extended “three-in-one” block after total knee arthroplasty: continuous versus patient-controlled techniques. Anesth Analg 2000;91:176–180.PubMedCrossRefGoogle Scholar
  232. 232.
    De Kock MF, Pichon G, Scholtes JL. Intraoperative clonidine enhances postoperative morphine patient-controlled analgesia. Can J Anaesth 1992;39:537–544.PubMedCrossRefGoogle Scholar
  233. 233.
    Wong HY, Carpenter RL, Kopacz DJ, et al. A randomized, double-blind evaluation of ketorolac tromethamine for postoperative analgesia in ambulatory surgery patients. Anesthesiology 1993;78:6–14.PubMedCrossRefGoogle Scholar
  234. 234.
    Milligan KR, Convery PN, Weir P, Quinn P, Connolly D. The efficacy and safety of epidural infusions of levobupivacaine with and without clonidine for postoperative pain relief in patients undergoing total hip replacement. Anesth Analg 2000;91:393–397.PubMedCrossRefGoogle Scholar
  235. 235.
    Capdevila X, Barthelet Y, Biboulet P, Ryckwaert Y, Rubenovitch J, d’Athis F. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology 1999;91:8–15.PubMedCrossRefGoogle Scholar
  236. 236.
    Mahoney OM, Noble PC, Davidson J, Tullos HS. The effect of continuous epidural analgesia on postoperative pain, rehabilitation, and duration of hospitalization in total knee arthroplasty. Clin Orthop 1990:30–37.Google Scholar
  237. 237.
    Williams-Russo P, Sharrock NE, Haas SB, et al. Randomized trial of epidural versus general anesthesia: outcomes after primary total knee replacement. Clin Orthop 1996: 199–208.Google Scholar
  238. 238.
    Cullen DJ, Sweitzer BJ, Bates DW, Burdick E, Edmondson A, Leape LL. Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units. Crit Care Med 1997;25:1289–1297.PubMedCrossRefGoogle Scholar
  239. 239.
    Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA 1995;274:29–34.PubMedCrossRefGoogle Scholar
  240. 240.
    Parikh SS, Chung F. Postoperative delirium in the elderly. Anesth Analg 1995;80:1223–1232.PubMedCrossRefGoogle Scholar
  241. 241.
    Ritchie K, Polge C, de Roquefeuil G, Djakovic M, Ledesert B. Impact of anesthesia on the cognitive functioning of the elderly. Int Psychogeriatr 1997;9:309–326.PubMedCrossRefGoogle Scholar
  242. 242.
    Grichnik KP, Ijsselmuiden AJ, D’Amico TA, et al. Cognitive decline after major noncardiac operations: a preliminary prospective study. Ann Thorac Surg 1999;68: 1786–1791.PubMedCrossRefGoogle Scholar
  243. 243.
    Billig N, Stockton P, Cohen-Mansfield J. Cognitive and affective changes after cataract surgery in an elderly population. Am J Geriatr Psychiatry 1995;4:29–38.Google Scholar
  244. 244.
    Goldstein MZ, Young BL, Fogel BS, Benedict RH. Occurrence and predictors of short-term mental and functional changes in older adults undergoing elective surgery under general anesthesia. Am J Geriatr Psychiatry 1998;6: 42–52.PubMedGoogle Scholar
  245. 245.
    Rogers MP, Liang MH, Daltroy LH, et al. Delirium after elective orthopedic surgery: risk factors and natural history. Int J Psychiatry Med 1989;19:109–121.PubMedGoogle Scholar
  246. 246.
    Williams-Russo P, Sharrock NE, Mattis S, Szatrowski TP, Charlson ME. Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA 1995;274:44–50.PubMedCrossRefGoogle Scholar
  247. 247.
    Moller JT, Cluitmans P, Rasmussen LS, et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. (ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction). Lancet 1998;351:857–861.PubMedCrossRefGoogle Scholar
  248. 248.
    McKhann GM, Goldsborough MA, Borowicz LM Jr, et al. Cognitive outcome after coronary artery bypass: a one-year prospective study. Ann Thorac Surg 1997;63: 510–515.PubMedCrossRefGoogle Scholar
  249. 249.
    Newman MF, Kramer D, Croughwell ND, et al. Differential age effects of mean arterial pressure and rewarming on cognitive dysfunction after cardiac surgery. Anesth Analg 1995;81:236–242.PubMedCrossRefGoogle Scholar
  250. 250.
    Selnes OA, Goldsborough MA, Borowicz LM, Enger C, Quaskey SA, McKhann GM. Determinants of cognitive change after coronary artery bypass surgery: a multifactorial problem. Ann Thorac Surg 1999;67:1669–1676.PubMedCrossRefGoogle Scholar
  251. 251.
    Chung FF, Chung A, Meier RH, Lautenschlaeger E, Seyone C. Comparison of perioperative mental function after general anaesthesia and spinal anaesthesia with intravenous sedation. Can J Anaesth 1989;36:382–387.PubMedGoogle Scholar
  252. 252.
    Marcantonio ER, Juarez G, Goldman L, et al. The relationship of postoperative delirium with psychoactive medications. JAMA 1994;272:1518–1522.PubMedCrossRefGoogle Scholar
  253. 253.
    Herrick IA, Ganapathy S, Komar W, et al. Postoperative cognitive impairment in the elderly. Choice of patientcontrolled analgesic opioid. Anaesthesia 1996;51:356–360.PubMedCrossRefGoogle Scholar
  254. 254.
    Crul BJ, Hulstijn W, Burger IC. Influence of the type of anaesthesia on post-operative subjective physical wellbeing and mental function in elderly patients. Acta Anaesthesiol Scand 1992;36:615–620.PubMedGoogle Scholar
  255. 255.
    Tune LE, Damlouji NF, Holland A, Gardner TJ, Folstein MF, Coyle JT. Association of postoperative delirium with raised serum levels of anticholinergic drugs. Lancet 1981; 2:651–653.PubMedCrossRefGoogle Scholar
  256. 256.
    Brebner J, Hadley L. Experiences with physostigmine in the reversal of adverse post-anaesthetic effects. Can Anaesth Soc J 1976;23:574–581.PubMedGoogle Scholar
  257. 257.
    Marcantonio ER, Goldman L, Orav EJ, Cook EF, Lee TH. The association of intraoperative factors with the development of postoperative delirium. Am J Med 1998;105: 380–384.PubMedCrossRefGoogle Scholar
  258. 258.
    Dodds C, Allison J. Postoperative cognitive deficit in the elderly surgical patient. Br J Anaesth 1998;81:449–462.PubMedGoogle Scholar
  259. 259.
    Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability. JAMA 1996; 275:852–857.PubMedCrossRefGoogle Scholar
  260. 260.
    Inouye SK. Delirium in hospitalized older patients: recognition and risk factors. J Geriatr Psychiatry Neurol 1998; 11:118–125; discussion 157–158.PubMedGoogle Scholar
  261. 261.
    Inouye SK. Delirium in hospitalized older patients. Clin Geriatr Med 1998;14:745–764.PubMedGoogle Scholar
  262. 262.
    Lynch EP, Lazor MA, Gellis JE, Orav J, Goldman L, Marcantonio ER. The impact of postoperative pain on the development of postoperative delirium. Anesth Analg 1998;86:781–785.PubMedCrossRefGoogle Scholar
  263. 263.
    Koenig HG, George LK, Stangl D, Tweed DL. Hospital stressors experienced by elderly medical inpatients: developing a Hospital Stress Index. Int J Psychiatry Med 1995; 25:103–122.PubMedCrossRefGoogle Scholar
  264. 264.
    Inouye SK. Predisposing and precipitating factors for delirium in hospitalized older patients. Dement Geriatr Cogn Disord 1999;10:393–400.PubMedCrossRefGoogle Scholar
  265. 265.
    Inouye SK, Bogardus ST Jr, Charpentier PA, et al. A multicomponent intervention to prevent delirium in hospitalized older patients [see comments]. N Engl J Med 1999; 340:669–676.PubMedCrossRefGoogle Scholar
  266. 266.
    Inouye SK, Rushing JT, Foreman MD, Palmer RM, Pompei P. Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. J Gen Intern Med 1998; 13:234–242.PubMedCrossRefGoogle Scholar
  267. 267.
    Inouye SK, Viscoli CM, Horwitz RI, Hurst LD, Tinetti ME. A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Ann Intern Med 1993;119:474–481.PubMedGoogle Scholar
  268. 268.
    Goldstein MZ. Cognitive change after elective surgery in nondemented older adults. Am J Geriatr Psychiatry 1993; 1:118–125.Google Scholar
  269. 269.
    McDowell I, Newell C. Measuring Health: a Guide to Rating Scales and Questionnaires. 2nd ed. New York: Oxford University Press; 1996.Google Scholar
  270. 270.
    Froehlich TE, Robison JT, Inouye SK. Screening for dementia in the outpatient setting: the time and change test [see comments]. J Am Geriatr Soc 1998;46:1506–1511.PubMedGoogle Scholar
  271. 271.
    Kalisvaart KJ, de Jonghe JF, Bogaards MJ, et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc 2005;53:1658–1666.PubMedCrossRefGoogle Scholar
  272. 272.
    Freedman GM, Peruvemba R. Geriatric pain management. The anesthesiologist’s perspective. Anesthesiol Clin North Am 2000;18:123–141, vii.CrossRefGoogle Scholar
  273. 273.
    Parmelee PA, Katz IR, Lawton MP. The relation of pain to depression among institutionalized aged. J Gerontol 1991;46:15–21.Google Scholar
  274. 274.
    Farrell MJ, Gerontol M, Gibson SJ, Helme RD. The effect of medical status on the activity level of older pain clinic patients. J Am Geriatr Soc 1995;43:102–107.PubMedGoogle Scholar
  275. 275.
    Sorkin BA, Rudy TE, Hanlon RB, Turk DC, Stieg RL. Chronic pain in old and young patients: differences appear less important than similarities. J Gerontol 1990;45: 64–68.Google Scholar
  276. 276.
    Cutler RB, Fishbain DA, Rosomoff RS, Rosomoff HL. Outcomes in treatment of pain in geriatric and younger age groups. Arch Phys Med Rehabil 1994;75:457–464.PubMedCrossRefGoogle Scholar
  277. 277.
    Lipman AG. Analgesic drugs for neuropathic and sympathetically maintained pain. Clin Geriatr Med 1996;12: 501–515.PubMedGoogle Scholar
  278. 278.
    Arner S, Meyerson BA. Lack of analgesic effect of opioids on neuropathic and idiopathic forms of pain. Pain 1988; 33:11–23.PubMedCrossRefGoogle Scholar
  279. 279.
    Swerdlow M. Anticonvulsants in the therapy of neuralgic pain. Pain Clinic 1986;1:9–19.Google Scholar
  280. 280.
    Stanton-Hicks M, Baron R, Boas R, et al. Complex regional pain syndromes: guidelines for therapy. Clin J Pain 1998; 14:155–166.PubMedCrossRefGoogle Scholar
  281. 281.
    Max MB, Kishore-Kumar R, Schafer SC, et al. Efficacy of desipramine in painful diabetic neuropathy: a placebocontrolled trial. Pain 1991;45:3–9; discussion 1–2.PubMedCrossRefGoogle Scholar
  282. 282.
    Cutler RB, Fishbain DA, Lu Y, Rosomoff RS, Rosomoff HL. Prediction of pain center treatment outcome for geriatric chronic pain patients. Clin J Pain 1994;10: 10–17.PubMedCrossRefGoogle Scholar
  283. 283.
    Carmichael JK. Treatment of herpes zoster and postherpeutic neuralgia. Am Fam Physician 1991;44:203–210.PubMedGoogle Scholar
  284. 284.
    Watson CP, Evans RJ, Watt VR. Post-herpetic neuralgia and topical capsaicin. Pain 1988;33:333–340.PubMedCrossRefGoogle Scholar
  285. 285.
    Hwang SM, Kang YC, Lee YB, Yoon KB, Ahn SK, Choi EH. The effects of epidural blockade on the acute pain in herpes zoster. Arch Dermatol 1999;135:1359–1364.PubMedCrossRefGoogle Scholar
  286. 286.
    Chiarello SE. Tumescent infiltration of corticosteroids, lidocaine, and epinephrine into dermatomes of acute herpetic pain or postherpetic neuralgia. Arch Dermatol 1998; 134:279–281.PubMedCrossRefGoogle Scholar
  287. 287.
    Alper BS, Lewis PR. Does treatment of acute herpes zoster prevent or shorten postherpetic neuralgia? J Fam Pract 2000;49:255–264.PubMedGoogle Scholar
  288. 288.
    Kost RG, Straus SE. Postherpetic neuralgia. Predicting and preventing risk. Arch Intern Med 1997;157:1166–1167.PubMedCrossRefGoogle Scholar
  289. 289.
    Weller TH. Varicella and herpes zoster. Changing concepts of the natural history, control, and importance of a not-sobenign virus. N Engl J Med 1983;309:1434–1440.PubMedGoogle Scholar
  290. 290.
    Ragozzino MW, Melton LJ 3rd, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Medicine (Baltimore) 1982;61:310–316.Google Scholar
  291. 291.
    Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch Intern Med 1995;155: 1605–1609.PubMedCrossRefGoogle Scholar
  292. 292.
    Choo PW, Galil K, Donahue JG, Walker AM, Spiegelman D, Platt R. Risk factors for postherpetic neuralgia. Arch Intern Med 1997;157:1217–1224.PubMedCrossRefGoogle Scholar
  293. 293.
    Galil K, Choo PW, Donahue JG, Platt R. The sequelae of herpes zoster. Arch Intern Med 1997;157:1209–1213.PubMedCrossRefGoogle Scholar
  294. 294.
    Miller AE. Selective decline in cellular immune response to varicella-zoster in the elderly. Neurology 1980;30:582–587.PubMedGoogle Scholar
  295. 295.
    Berger R, Florent G, Just M. Decrease of the lymphoproliferative response to varicella-zoster virus antigen in the aged. Infect Immun 1981;32:24–27.PubMedGoogle Scholar
  296. 296.
    Burke BL, Steele RW, Beard OW, Wood JS, Cain TD, Marmer DJ. Immune responses to varicella-zoster in the aged. Arch Intern Med 1982;142:291–293.PubMedCrossRefGoogle Scholar
  297. 297.
    Levin MJ, Murray M, Rotbart HA, Zerbe GO, White CJ, Hayward AR. Immune response of elderly individuals to a live attenuated varicella vaccine. J Infect Dis 1992;166: 253–259.PubMedGoogle Scholar
  298. 298.
    Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med 2005;352:2271–2284.PubMedCrossRefGoogle Scholar
  299. 299.
    Byrd JC, McGrail LH, Hospenthal DR, Howard RS, Dow NA, Diehl LF. Herpes virus infections occur frequently following treatment with fludarabine: results of a prospective natural history study. Br J Haematol 1999; 105:445–447.PubMedCrossRefGoogle Scholar
  300. 300.
    Sengstaken EA, King SA. The problems of pain and its detection among geriatric nursing home residents. J Am Geriatr Soc 1993;41:541–544.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Christopher J. Jankowski
    • 1
  • David J. Cook
    • 1
  1. 1.Department of AnesthesiologyMayo Clinic College of MedicineRochesterUSA

Personalised recommendations