Basic principles of anaesthesia of older persons

As age increases, the functions of the body decline, and older persons need special attention when receiving anaesthesia. The effects of anaesthesia on older patients are complex and involve cardiovascular, respiratory and cognitive functions. In order to ensure the safety and comfort of elderly patients in the process of anaesthesia, the following basic principles must be observed:1. Individualized assessmenta. Detailed medical history and medical examination: comprehensive medical history collection and medical examination prior to anaesthesia. This includes knowledge of chronic diseases (such as hypertension, diabetes, heart disease, etc.), past surgery and anaesthesia history, drug allergy, etc. of older patients. This information helps to develop appropriate anaesthesia programmes to reduce the risk of surgery and anaesthesia.b. Body function assessment: The physical functions of older patients are often affected, including the heart, lung, liver and kidney. An electrocardiogram, chest X-ray, heart ultrasound, lung function test and liver and kidney function check are required to assess the health of these systems and adjust the anesthesia programme accordingly.2. Safety prioritya. Select the appropriate anaesthesia: the appropriate anaesthesia (e.g., general anaesthesia, regional anaesthesia or local anaesthesia) according to the nature of the operation and the patient ‘ s state of health. Anaesthesia choices for elderly patients need to be combined to minimize the risk of anaesthesia.b. Monitoring and management: Life signs of elderly patients, such as heart rate, blood pressure, breathing frequency and blood oxygen saturation, need to be strictly monitored during anaesthesia. Ensure that the use of narcotic drugs is safe and effective and adjust the dose of narcotic drugs and drugs to real-time monitoring data.3. Drug selection and dose adjustmenta. Drug selection: The response of older patients to narcotic drugs may be different from that of younger patients. The choice of drugs needs to take into account their metabolic and excretion characteristics and to avoid the use of drugs that can cause excessive burdens or side effects on older patients.b. Dose adjustment: Due to the slow pace of drug metabolism in older patients and the length of time the drug remains in the body, dose adjustment is essential. Anaesthetists need to accurately adjust the dose of anaesthesia to the weight, state of health and response of older patients in order to prevent overdose or side effects.4. Pre-operative preparationa. Pre-operative assessment and preparation: Ensure that pre-operative evaluation is comprehensive, including necessary examinations such as EKG, blood tests, etc. At the same time, the patient ‘ s requirements for fasting are understood and properly prepared to reduce the occurrence of surgical and post-operative complications.(b) Psychological support: psychological support should be provided to elderly patients prior to surgery to help them reduce anxiety and fear. A detailed explanation of the procedure and the anesthesia programme can help the patient relax and increase confidence in the operation.5. Artificial managementa. Surveillance of the depth of anaesthesia: The management of anaesthesia is essential to ensure the comfort and safety of elderly patients during surgery. Anaesthetists need to adjust the depth of anaesthesia to the progress of the operation and the patient ‘ s reaction dynamics in order to prevent excessive or inadequate anaesthesia.b. Risk management: Older patients may be more vulnerable to anaesthesia-related complications such as heart disorders, respiratory problems, etc. Anesthesia teams need to have the capacity and experience to deal with these complications and to ensure a rapid and effective response to emergencies during surgery.Post-operative carea. Post-operative monitoring: Post-operative care requires detailed monitoring of the recovery of older patients, including the restoration of consciousness, stabilization of vital signs and pain management. Timely identification and treatment of post-operative complications, such as infection, haemorrhage, etc.b. Pain management: The perception and tolerance of pain among older patients may be different from that of younger patients. Post-operative pain management should be individualized and the pain programme adapted to the needs and feedback of the patient to ensure a comfortable recovery process.7. Multidisciplinary collaborationa. Multidisciplinary team collaboration: In the anaesthesia of older patients, multidisciplinary team collaboration is essential. Anaesthetists, surgeons, nursing personnel and other relevant medical professionals need to work closely together to ensure that the operation and the anesthesia process proceed smoothly.b. Family involvement: Family support and participation are also important for the post-operative rehabilitation of elderly patients. Anaesthesia teams should communicate with families, provide post-operative care guidance and support to help them better care for their patients.As older persons face more risks and challenges in the process of anaesthesia, the basic principles of individualized assessment, safety priorities, drug selection and dose adjustment, pre-operative preparation, surgical management, post-operative care and multidisciplinary cooperation must be followed. Through careful assessment, professional management and comprehensive post-operative care, the risk of anaesthesia for older patients can be minimized and their safety and comfort enhanced. The experience and professionalism of anaesthesia teams is essential to ensure the health of older patients.