Increased longevity and anesthesia

Abstract

The increased life expectancy, associated with age-related comorbidities, results in the continuous growth of the geriatric surgical population. Due to this increase, every anesthesiologist will be involved, at some point in the care of an elderly patient. A better perioperative understanding of the problems related to anesthesia may help to improve the outcome, reducing the morbidity of the procedures. In this group, decreased physiological reserve impairs the body’s ability to maintain homeostasis during periods of stress, leading to physical and cognitive dysfunction resulting in severe perioperative complications. Consequently, the importance of performing an individualized preoperative assessment and identifying potential risk factors needs to be kept in mind. The choice of anesthesia should be evaluated on a case-by-case basis, and tailored to the patient’s health status, type of operation, coexisting diseases and patient’s medications in order to provide the most effective perioperative treatment. The development of new techniques will provide minimally invasive procedures, with lower morbidity increasing safety, especially in high-risk patients. A larger contingent of elderly patients will undergo anesthesia in the future, not only because of the population increase, but also because of age-related increased probability that a person needs a surgical procedure.