Monitored anaesthesia care in the elderly: guidelines and recommendations.

摘要: As the number of elderly patients undergoing surgery continues to rise, it is important consider anaesthetic options that minimize physiological stress in these patients. Monitored anaesthesia care (MAC), or sedation and monitoring during surgery, an attractive option for certain common procedures. However, those administering MAC must normal decline functional reserve aged >70 years. This includes loss compensation hypovolaemia, decreased peripheral vascular resistance, altered mental status reduced response hypoxia hypercarbia associated with perioperative sedated state this population. In addition, vigilance necessary identify co-morbid states, which increase incidence age often present atypically. Elderly have increased sensitivity all sedatives opioids (doubled by 80 years, quadrupled 90 years benzodiazepines). a result changes body composition, as well senescence renal hepatic function, time onset offset even short-acting will be prolonged. There also extreme variability among Anaesthetic dosing should smaller increments elderly, boluses half infusions much two-thirds. Caution exercised through full intra-operative postoperative status, oxygenation perfusion states. Pain best treated using doses multimodal regimen, aim being reduce adverse effects while ensuring adequate pain relief. way, huge range procedures can safely performed our aging population expectations early return baseline status.