As global population ageing increases, the number of surgical procedures for older patients is increasing, placing higher demands on anaesthesia management. The management of anaesthesia is particularly complex and challenging because of the physical decline of older patients, which often combines multiple chronic diseases. The purpose of this paper is to explore the characteristics and challenges of anaesthesia management for older patients, with a view to improving the safety of anaesthesia and the quality of anesthesia management. Characteristics of the management of anaesthesia in the elderly The MAC value for inhalation of anaesthesia (minimum effective pulmonary bubble concentration) decreased with age, and the use of intravenous drugs such as propyrophenol and midarram required a dose reduction. The effect of opioid analgesics can be twice as high among older persons, and the pro-Atracu ammonium in myopines is not affected by age. When anesthesia occurs in the vertebrae, the sterilisation of the elderly is short, proliferating, and epidural anesthesia is shorter and has a wide range of resistance. Loss of function of organs: A diminished function of the cardiovascular system, prone to blood pressure fluctuations and cardiovascular accidents. Respiratory system functions are weakened and are prone to respiratory difficulties and low oxygen haematosis. The reduced metabolic function leads to slow drug metabolism and is prone to drug accumulation. The function of the nervous system is weakened, and there is a high risk of anaesthesia with delayed awakening and cognitive impairment. Mental characteristics: Older patients often suffer from anxiety, fear, reduced cognitive function and psychological dependence, which may affect anaesthesia and post-operative recovery. The challenge of anaesthesia management for elderly patients Pre-operative assessment and preparation: An overall assessment of the age, state of health, history of drug allergy, type of operation and psychological condition of the patient is required prior to the surgery. Older patients often combine a number of chronic diseases, such as hypertension, coronary heart disease and diabetes, which increases the risk of anaesthesia. The basic disease must be actively controlled prior to the operation and the physical condition of the patient should be optimized. Anaesthesia selection and management: Select the appropriate anaesthesia according to the age, physical condition and surgical needs of the patient. Priority is given to local anesthesia, reducing the use of whole-body anesthesia. The vital signs of the patient, including blood pressure, heart rate, breathing, blood oxygen saturation, etc., need to be closely monitored during anaesthesia to ensure the safety of the anaesthesia. Hemodynamic stability should be maintained during the operation to avoid blood pressure fluctuations and low organ infusion. Post-operative management: Post-operative monitoring and management are needed to prevent complications. Post-operative pain management is very important, and it is important to rationalize the use of painkillers, to alleviate post-operative pain and to avoid respiratory depression caused by excessive painkillers. After the operation, there is a need to prevent complications such as infection, haemorrhage and haemorrhage, to provide rehabilitation guidance and to help the patient recover his or her physical function as soon as possible. Dose adjustment of anaesthesia: Older patients are more sensitive to anaesthesia and need to adjust anaesthesia to the age, weight, state of health, etc. Inadequate anaesthesia can cause pain to patients during surgery and affect the effects of the operation; excessive anaesthesia can lead to adverse effects such as respiratory inhibition and decreased blood pressure. Anesthetists are required to follow closely the vital signs of the patient and to adjust the dose in a timely manner in accordance with the patient ‘ s response. Circulatory management: The management of blood flow mechanics during circumcise for elderly patients is one of the difficulties of anaesthesia management. Older patients are highly susceptible to rapid reductions in vascular tension and blood pressure after anaesthesia. Blood pressure should be maintained between 20 and 20 per cent of the state of pre-operative calm, and within 20 per cent of the degree of silence for patients with a pre-operative combination of severe cerebrovascular vessels. The management of anaesthesia among older patients has its unique characteristics and challenges. Anesthesiologists need to be fully aware of the physical and psychological characteristics of elderly patients, to conduct a comprehensive pre-operative assessment and preparation, to choose appropriate anesthesia methods and management strategies, and to strengthen the monitoring and post-operative monitoring and management in order to ensure the safety of anesthesia and the quality of circumscopal management. Individualized anaesthesia management and fine excursion management can reduce the risk of anaesthesia among elderly patients, increase the success rate of surgery and promote post-operative rehabilitation.
Anaesthesia.
