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Management of Ambulatory Anesthesia in Older Adults

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@article{e491677d006848618d02f0179eb184ee,
title = "Management of Ambulatory Anesthesia in Older Adults",
abstract = "The number of older patients is increasing globally. Combined with the growing number of ambulatory surgeries, many older patients will undergo ambulatory surgery in the future. The ambulatory setting offers many advantages: early mobilization, higher patient satisfaction, lower costs, and a low incidence of several complications such as infections and thromboembolic events. Moreover, cognitive recovery seems to be enhanced compared with in-hospital surgery, and both frail patients and patients with dementia can benefit from ambulatory surgery. This review provides suggestions for managing perioperative anesthesia for older patients in the ambulatory setting. Not all older patients are eligible for ambulatory surgery, and clinicians must be aware of risk factors for complications, especially frailty. Most anesthesia techniques and agents can be used in the ambulatory setting, but short-acting agents are preferred to ensure fast recovery. Both regional and general anesthesia are useful, but clinicians must be familiar with the physiological changes and specific implications in the older population. The older patients are more sensitive to anesthetic agents, meaning that a lower dose is needed to obtain the desired effect. However, they exhibit huge variation in pharmacodynamics and pharmacokinetics. Prolonged onset time may lead to overdosing and extended recovery. After surgery, effective pain management with opioid minimization is essential to ensure rapid recovery.",
keywords = "Age Factors, Aged, Ambulatory Surgical Procedures/adverse effects, Anesthesia/methods, Female, Humans, Pain Management/methods, Postoperative Complications/prevention & control, Preoperative Care/methods, Risk Factors",
author = "Joachim Hansen and Rasmussen, {Lars Simon} and Jacob Steinmetz",
year = "2020",
month = "1",
day = "1",
doi = "10.1007/s40266-020-00803-9",
language = "English",
volume = "37",
pages = "863--874",
journal = "Drugs and Aging",
issn = "1170-229X",
publisher = "Adis International Ltd",
number = "12",

}

RIS

TY - JOUR

T1 - Management of Ambulatory Anesthesia in Older Adults

AU - Hansen, Joachim

AU - Rasmussen, Lars Simon

AU - Steinmetz, Jacob

PY - 2020/1/1

Y1 - 2020/1/1

N2 - The number of older patients is increasing globally. Combined with the growing number of ambulatory surgeries, many older patients will undergo ambulatory surgery in the future. The ambulatory setting offers many advantages: early mobilization, higher patient satisfaction, lower costs, and a low incidence of several complications such as infections and thromboembolic events. Moreover, cognitive recovery seems to be enhanced compared with in-hospital surgery, and both frail patients and patients with dementia can benefit from ambulatory surgery. This review provides suggestions for managing perioperative anesthesia for older patients in the ambulatory setting. Not all older patients are eligible for ambulatory surgery, and clinicians must be aware of risk factors for complications, especially frailty. Most anesthesia techniques and agents can be used in the ambulatory setting, but short-acting agents are preferred to ensure fast recovery. Both regional and general anesthesia are useful, but clinicians must be familiar with the physiological changes and specific implications in the older population. The older patients are more sensitive to anesthetic agents, meaning that a lower dose is needed to obtain the desired effect. However, they exhibit huge variation in pharmacodynamics and pharmacokinetics. Prolonged onset time may lead to overdosing and extended recovery. After surgery, effective pain management with opioid minimization is essential to ensure rapid recovery.

AB - The number of older patients is increasing globally. Combined with the growing number of ambulatory surgeries, many older patients will undergo ambulatory surgery in the future. The ambulatory setting offers many advantages: early mobilization, higher patient satisfaction, lower costs, and a low incidence of several complications such as infections and thromboembolic events. Moreover, cognitive recovery seems to be enhanced compared with in-hospital surgery, and both frail patients and patients with dementia can benefit from ambulatory surgery. This review provides suggestions for managing perioperative anesthesia for older patients in the ambulatory setting. Not all older patients are eligible for ambulatory surgery, and clinicians must be aware of risk factors for complications, especially frailty. Most anesthesia techniques and agents can be used in the ambulatory setting, but short-acting agents are preferred to ensure fast recovery. Both regional and general anesthesia are useful, but clinicians must be familiar with the physiological changes and specific implications in the older population. The older patients are more sensitive to anesthetic agents, meaning that a lower dose is needed to obtain the desired effect. However, they exhibit huge variation in pharmacodynamics and pharmacokinetics. Prolonged onset time may lead to overdosing and extended recovery. After surgery, effective pain management with opioid minimization is essential to ensure rapid recovery.

KW - Age Factors

KW - Aged

KW - Ambulatory Surgical Procedures/adverse effects

KW - Anesthesia/methods

KW - Female

KW - Humans

KW - Pain Management/methods

KW - Postoperative Complications/prevention & control

KW - Preoperative Care/methods

KW - Risk Factors

U2 - 10.1007/s40266-020-00803-9

DO - 10.1007/s40266-020-00803-9

M3 - Review

VL - 37

SP - 863

EP - 874

JO - Drugs and Aging

JF - Drugs and Aging

SN - 1170-229X

IS - 12

ER -

ID: 61082363