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首页> 外文期刊>Current opinion in anaesthesiology >Anaesthesia for the elderly outpatient: preoperative assessment and evaluation, anaesthetic technique and postoperative pain management.
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Anaesthesia for the elderly outpatient: preoperative assessment and evaluation, anaesthetic technique and postoperative pain management.

机译：老年门诊麻醉：术前评估和评估，麻醉技术和术后疼痛管理。

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PURPOSE OF REVIEW: Epidemiological data show a continuous expansion of elderly population, associated with an increased demand for surgical treatments by older patients. Geriatric anaesthesia is emerging as a new subspecialty. Outpatient anaesthesia for elderly patients requires greater specific knowledge and skills. Given the high economic and social pressure, anaesthetists will be requested to treat an increasing number of elderly as outpatients. RECENT FINDINGS: Functional status as a criterion for preoperative assessment of older patients has been introduced in the last years. In comparison to inpatient, outpatient setting seems to reduce the risk of postoperative cognitive disorders after surgery. Heart failure has shown to be an important risk factor of perioperative complication and death in the elderly; when more than mild, it contraindicates day surgery. Drug-eluting stents, which require a double antiaggregative therapy for 12 months after positioning, formally exclude patients from day surgery for that period. Sedation as a part of Monitored Anaesthesia Care (MAC) has shown to be potentially dangerous, due to increased risk of hypoxic complications and increased likelihood of cognitive disturbances. Effective postoperative pain treatment after geriatric day surgery requires careful pain assessment and drug titration. In the future, the development of telematic communication systems will extend indications. SUMMARY: Recent findings contribute to a better comprehension of the most important specificities of elderly patients undergoing day surgery and provide basic elements for a safe perioperative management in the outpatient setting.
机译：审查目的：流行病学数据显示，老年人口的持续增加，与老年患者对外科治疗的需求增加有关。老年麻醉正在成为一种新的亚专业。老年患者的门诊麻醉需要更多的专门知识和技能。考虑到巨大的经济和社会压力，将要求麻醉师将越来越多的老年人作为门诊病人。最近的发现：近年来，已将功能状态作为对老年患者进行术前评估的标准。与住院患者相比，门诊患者似乎减少了术后认知障碍的风险。心力衰竭已被证明是老年人围手术期并发症和死亡的重要危险因素。如果轻度以上，则禁止日间手术。药物洗脱支架在定位后需要进行12个月的双重抗凝治疗，从而正式将该患者从当天手术中排除。镇静作为监测性麻醉护理（MAC）的一部分，由于低氧并发症的风险增加和认知障碍的可能性增加，已显示出潜在的危险。老年日间手术后有效的术后疼痛治疗需要仔细的疼痛评估和药物滴定。将来，远程通讯系统的发展将扩展适应症。摘要：最近的发现有助于更好地理解接受日间手术的老年患者的最重要特异性，并为门诊患者安全围手术期管理提供了基本要素。

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