Perioperative management of elderly patients undergoing surgery with regional anesthesia

ABSTRACT

Regional anesthesia can reduce deep vein thrombosis and pulmonary embolism by suppression of the stress responses caused by surgery via the blocking of the afferent and efferent pathways of nerve conduction. It is also effective for control of acute postoperative pain, and compared to general anesthesia, it reduces bleeding during surgery and postoperative respiratory complications. The functional reserves of important organs are reduced in elderly patients although the progression and degree are different from patient to patient. Thus, it is important that safe and appropriate perioperative care including anesthesia be delivered only after a thorough evaluation of the current status of an elderly patient. In this regard, regional anesthesia is worth performing for elderly patients considering its characteristic advantages over general anesthesia. Peripheral nerve blocks using ultrasound are another alternative in elderly patients who might have difficulty undergoing regional or general anesthesia.