Special considerations for general anesthesia in elderly patients

ABSTRACT

The aged population is increasing rapidly, and the range of subjects undergoing surgery under general anesthesia is also expanding. Organ dysfunction reduces physiologic reserve, and comorbidity and polypragmasy increase the risk of postoperative complications. All anesthetic agents and techniques can be employed, if individualized to each patient's condition. Careful intraoperative monitoring and proper management to maintain homeostasis can reduce the risk of complications. Experienced anesthesiologists must choose the appropriate drug and adjust the dose individually, considering the physiologic changes that take place in the elderly. Goal-directed fluid replacement is mandatory. Anesthesiologists and surgeons should understand the risks experienced by the elderly and their fragility, and will achieve optimal outcomes if they communicate and cooperate closely.