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Zeitschrift für Gerontologie und Geriatrie

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01.06.2011 | Original Contribution

Perioperative care of the older patient

verfasst von: E. Blommers, M. Klimek, K.A. Hartholt, T.J.M. van der Cammen, J. Klein, P.G. Noordzij, MD, PhD.

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 3/2011

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Abstract

Nearly 60% of the Dutch population undergoing surgery is aged 65 years and over. Older patients are at increased risk of developing perioperative complications (e.g., myocardial infarction, pneumonia, or delirium), which may lead to a prolonged hospital stay or death. Preoperative risk stratification calculates a patient’s risk by evaluating the presence and extent of frailty, pathophysiological risk factors, type of surgery, and the results of (additional) testing. Type of anesthesia, fluid management, and pain management affect outcome of surgery. Recent developments focus on multimodal perioperative care of the older patient, using minimally invasive surgery, postoperative anesthesiology rounds, and early geriatric consultation.

Vorheriger Artikel Hilft das zahnmedizinische Bonussystem den stationär Pflegebedürftigen?

Nächster Artikel Sind Reinigungstabletten für die alltägliche Zahnprothesenhygiene geeignet?

Rooke GA (2003) Cardiovascular aging and anesthetic implications. J Cardiothorac Vasc Anesth 17(4):512–523PubMedCrossRef

Lee TH, Marcantonio ER, Mangione CM et al (1999) Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 100(10):1043–1049PubMed

McFalls EO, Ward HB, Moritz TE et al (2004) Coronary-artery revascularization before elective major vascular surgery. N Engl J Med 351(27):2795–2804PubMedCrossRef

Fleisher LA, Beckman JA, Brown KA et al (2007) ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery: executive summary. J Am Coll Cardiol 50(17):1707–1732PubMedCrossRef

Devereaux PJHO (2008) The perioperative ischemic evaluation (POISE) trial: a randomized controlled trial of metoprolol versus placebo in patients undergoing noncardiac surgery. Clin Res Cardiol 97:8

Allen S (1986) Respiratory considerations in the elderly surgical patient. Clin Anesthesiol 4:899–930

Qaseem A, Snow V, Fitterman N et al (2006) Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physicians. Ann Intern Med 144(8):575–580PubMed

Thorell A, Nygren J, Ljungqvist O (1999) Insulin resistance: a marker of surgical stress. Curr Opin Clin Nutr Metab Care 2(1):69–78PubMedCrossRef

Avenell A, Handoll HH (2006) Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev (4):CD001880

10.

Klafta JM, Roizen MF (1996) Current understanding of patients’ attitudes toward and preparation for anesthesia: a review. Anesth Analg 83(6):1314–1321PubMed

11.

Caumo W, Schmidt AP, Schneider CN et al (2001) Risk factors for postoperative anxiety in adults. Anaesthesia 56(8):720–728PubMedCrossRef

12.

Moiniche S, Kehlet H, Dahl JB (2002) A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology 96(3):725–741PubMedCrossRef

13.

Block BM, Liu SS, Rowlingson AJ et al (2003) Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA 290(18):2455–2463PubMedCrossRef

14.

Park WY, Thompson JS, Lee KK (2001) Effect of epidural anesthesia and analgesia on perioperative outcome: a randomized, controlled Veterans Affairs cooperative study. Ann Surg 234(4):560–569; discussion 9–71PubMedCrossRef

15.

Rodgers A, Walker N, Schug S et al (2000) Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 321(7275):1493PubMedCrossRef

16.

Liu SS, Wu CL (2007) Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg 104(3):689–702PubMedCrossRef

17.

Peyton PJ, Myles PS, Silbert BS et al (2003) Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients. Anesth Analg 96(2):548-554, table of contentsPubMed

18.

Lopes MR, Oliveira MA, Pereira VO et al (2007) Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial. Crit Care 11(5):R100PubMedCrossRef

19.

Sinclair S, James S, Singer M (1997) Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ 315(7113):909–912PubMed

20.

Gan TJ, Soppitt A, Maroof M et al (2002) Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology 97(4):820–826PubMedCrossRef

21.

Whatling PJ (2000) Intravenous fluids for abdominal aortic surgery. Cochrane Database Syst Rev (4):CD000991

22.

Kehlet H, Dahl JB (2003) Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362(9399):1921–1928PubMedCrossRef

23.

Solomon SD, McMurray JJ, Pfeffer MA et al (2005) Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention. N Engl J Med 352(11):1071–1080PubMedCrossRef

24.

Egbert AM, Parks LH, Short LM, Burnett ML (1990) Randomized trial of postoperative patient-controlled analgesia vs intramuscular narcotics in frail elderly men. Arch Intern Med 150(9):1897–1903PubMedCrossRef

25.

Marcantonio ER, Goldman L, Mangione CM et al (1994) A clinical prediction rule for delirium after elective noncardiac surgery. JAMA 271(2):134–139PubMedCrossRef

26.

Moller JT, Cluitmans P, Rasmussen LS et al (1998) Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet 351(9106):857–861PubMedCrossRef

27.

Williams-Russo P, Sharrock NE, Mattis S et al (1995) Cognitive effects after epidural vs general anesthesia in older adults. A randomized trial. JAMA 274(1):44–50PubMedCrossRef

28.

Marcantonio ER, Flacker JM, Wright RJ, Resnick NM (2001) Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 49(5):516–522PubMedCrossRef

29.

Kalisvaart KJ, Jonghe JF de, Bogaards MJ et al (2005) Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc 53(10):1658–1666PubMedCrossRef

30.

Kehlet H, Wilmore DW (2008) Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248(2):189–198PubMedCrossRef

31.

Larsen K, Sorensen OG, Hansen TB et al (2008) Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up. Acta Orthop 79(2):149–159PubMedCrossRef

32.

Morrison RS, Flanagan S, Fischberg D et al (2009) A novel interdisciplinary analgesic program reduces pain and improves function in older adults after orthopedic surgery. J Am Geriatr Soc 57(1):1–10PubMedCrossRef

Titel: Perioperative care of the older patient
verfasst von: E. Blommers
M. Klimek
K.A. Hartholt
T.J.M. van der Cammen
J. Klein
P.G. Noordzij, MD, PhD.
Publikationsdatum: 01.06.2011
Verlag: Springer-Verlag
Erschienen in: Zeitschrift für Gerontologie und Geriatrie / Ausgabe 3/2011
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI: https://doi.org/10.1007/s00391-011-0201-6

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Abstract

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