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Anesthesia for the elderly outpatient

Aurini, Luciaa; White, Paul F.b , *

Current Opinion in Anesthesiology: December 2014 - Volume 27 - Issue 6 - p 563–575
doi: 10.1097/ACO.0000000000000135
AMBULATORY ANESTHESIA: Edited by Thomas Fuchs-Buder
Editor's Choice

Purpose of review As the number of ambulatory surgery procedures continues to grow in an aging global society, the implementation of evidence-based perioperative care programs for the elderly patients will assume increased importance.

Recent findings Increasing evidence supports the expanded use of ambulatory surgery for managing elderly patients undergoing elective surgery procedures.

Summary This review article describes the demographics of ambulatory surgery in the elderly population. This review article describes the effects of aging on the responses of geriatric patients to anesthetic and analgesic drugs used during ambulatory surgery. Important considerations in the preoperative evaluation of elderly outpatients with co-existing diseases, as well as the advantages and disadvantages of different anesthetic techniques on a procedural-specific basis, and recommendations regarding the management of common postoperative side-effects (including delirium and cognitive dysfunction, fatigue, dizziness, pain, and gastrointestinal dysfunction) after ambulatory surgery. Finally, we discuss the future challenges related to the continued expansion of ambulatory surgery practice in this growing segment of our surgical population. The role of anesthesiologists as perioperative physicians is of critical importance for optimizing surgical outcomes for elderly patients undergoing ambulatory surgery. Providing high-quality, evidence-based anesthetic and analgesic care for elderly patients undergoing elective operations on an ambulatory basis will assume greater importance in the future.

aAnesthesiology and Intensive care Department, Bologna University, Bologna, Italy

bDepartment of Anesthesia, Cedars-Sinai Medical Center in Los Angeles, Los Angeles, California, USA

*Visiting Scientist at the Rizzoli Instituto at the University of Bologna, Italy.

Correspondence to Dr Paul F. White, PhD, MD, FANZCA, President, White Mountain Institute, 41299 Tallgrass, The Sea Ranch, CA 95497, USA. Tel: +1 214 770 3775; e-mail: whitemountaininstitute@hotmail.com

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