Abstract
Purpose of review: Populations across the world are getting older and requiring more surgery. Elderly patients present unique challenges to the anesthesiologist and anesthesia-care team. This review addresses some concerns when caring for an elderly patient. Specifically, we discuss postoperative cognitive decline (POCD) and postoperative delirium, perioperative beta-blockade and use of newer drugs, as well as older drugs. Recent findings: POCD has emerged as a new concern for anesthesiologists and their older patients. Several recent studies indicate that POCD is common after noncardiac surgery, with an incidence approaching 30-40% at discharge, although this incidence declines at 3 months. Some data suggest that POCD imparts risk for death. However, there is conflicting evidence. With regard to beta-blocker therapy, there has been growing concern about widespread use of beta-blocker therapy in the perioperative period, especially because such therapy might increase the risk for stroke. Summary: Elderly patients require focused diligent care. They are particularly sensitive to the many drugs that are administered in the perioperative period. Recent data suggest that POCD is a real concern, but it is unclear what, if anything, can be done to prevent this complication. Beta-blocker therapy is beneficial in select patients but its widespread use cannot be supported.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 449-454 |
| Number of pages | 6 |
| Journal | Current Opinion in Anaesthesiology |
| Volume | 23 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 2010 |
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Keywords
- delirium
- elderly
- myocardial infarction
- perioperative beta-blockers
- pharmacology
- postoperative cognitive dysfunction
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
- Medicine(all)
Cite this
Perioperative pharmacology in elderly patients. / Singh, Amrik; Antognini, Joseph F.
In: Current Opinion in Anaesthesiology, Vol. 23, No. 4, 08.2010, p. 449-454.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Perioperative pharmacology in elderly patients
AU - Singh, Amrik
AU - Antognini, Joseph F.
PY - 2010/8
Y1 - 2010/8
N2 - Purpose of review: Populations across the world are getting older and requiring more surgery. Elderly patients present unique challenges to the anesthesiologist and anesthesia-care team. This review addresses some concerns when caring for an elderly patient. Specifically, we discuss postoperative cognitive decline (POCD) and postoperative delirium, perioperative beta-blockade and use of newer drugs, as well as older drugs. Recent findings: POCD has emerged as a new concern for anesthesiologists and their older patients. Several recent studies indicate that POCD is common after noncardiac surgery, with an incidence approaching 30-40% at discharge, although this incidence declines at 3 months. Some data suggest that POCD imparts risk for death. However, there is conflicting evidence. With regard to beta-blocker therapy, there has been growing concern about widespread use of beta-blocker therapy in the perioperative period, especially because such therapy might increase the risk for stroke. Summary: Elderly patients require focused diligent care. They are particularly sensitive to the many drugs that are administered in the perioperative period. Recent data suggest that POCD is a real concern, but it is unclear what, if anything, can be done to prevent this complication. Beta-blocker therapy is beneficial in select patients but its widespread use cannot be supported.
AB - Purpose of review: Populations across the world are getting older and requiring more surgery. Elderly patients present unique challenges to the anesthesiologist and anesthesia-care team. This review addresses some concerns when caring for an elderly patient. Specifically, we discuss postoperative cognitive decline (POCD) and postoperative delirium, perioperative beta-blockade and use of newer drugs, as well as older drugs. Recent findings: POCD has emerged as a new concern for anesthesiologists and their older patients. Several recent studies indicate that POCD is common after noncardiac surgery, with an incidence approaching 30-40% at discharge, although this incidence declines at 3 months. Some data suggest that POCD imparts risk for death. However, there is conflicting evidence. With regard to beta-blocker therapy, there has been growing concern about widespread use of beta-blocker therapy in the perioperative period, especially because such therapy might increase the risk for stroke. Summary: Elderly patients require focused diligent care. They are particularly sensitive to the many drugs that are administered in the perioperative period. Recent data suggest that POCD is a real concern, but it is unclear what, if anything, can be done to prevent this complication. Beta-blocker therapy is beneficial in select patients but its widespread use cannot be supported.
KW - delirium
KW - elderly
KW - myocardial infarction
KW - perioperative beta-blockers
KW - pharmacology
KW - postoperative cognitive dysfunction
UR - http://www.scopus.com/inward/record.url?scp=77954661115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954661115&partnerID=8YFLogxK
U2 - 10.1097/ACO.0b013e328339ef22
DO - 10.1097/ACO.0b013e328339ef22
M3 - Article
C2 - 20489604
AN - SCOPUS:77954661115
VL - 23
SP - 449
EP - 454
JO - Current Opinion in Anaesthesiology
JF - Current Opinion in Anaesthesiology
SN - 0952-7907
IS - 4
ER -