Comprehensive management strategy of chronic diseases in elderly patients before anesthesia

With the passage of time, many elderly groups may encounter situations that require surgical treatment. However, due to the gradual decline of various functions of the body and the entanglement of chronic diseases, the preparation of pre-anesthesia has become extremely critical. Next, we will give you a detailed explanation of the key points related to the management of chronic diseases in the pre-anesthesia period of elderly patients, so as to help you understand and prepare more deeply. 1. Understanding the physiological changes of elderly patients When we enter the old age stage, our body will undergo a series of significant changes, which will have a profound impact on anesthesia and surgery. At the cardiovascular level, the ability of the heart to pump blood is weakened, the elasticity of blood vessels is declining, and conditions such as hypertension and coronary atherosclerotic heart disease occur from time to time. Respiratory field: The vital capacity is reduced, the breathing machine can be weakened, and shortness of breath and lack of physical strength are often felt. Renal system: Decreased renal filtration function and decreased drug excretion rate can easily lead to drug accumulation. Nervous system: Reactivity is reduced, memory is impaired, and sensitivity to anesthetics is significantly increased. 2. Types of chronic diseases and their effects The elderly are often accompanied by a variety of chronic diseases, which need special attention in the early stage of anesthesia. Hypertension: Blood pressure fluctuations can increase the risk of surgery and need to be effectively controlled before surgery. Diabetes: Abnormal fluctuations in blood sugar levels can affect the safety of surgery, which requires medication and dietary regulation to maintain stability. Coronary atherosclerotic heart disease: Impaired cardiac function may lead to intraoperative emergencies, requiring cardiac function assessment and emergency planning. Chronic obstructive pulmonary disease: Impaired lung function can affect respiratory support, and intensive lung function exercise and evaluation are needed before operation. 3. Core measures of chronic disease management in pre-anesthesia In order to ensure the safety of surgery, elderly patients need comprehensive chronic disease management in pre-anesthesia. Comprehensive assessment and chronic disease control: in-depth communication with medical experts to ensure effective management and control of chronic diseases. Consideration of the necessity of surgery: The risks and benefits of surgery should be weighed, and the elective surgery should be arranged in the stable stage of the disease as far as possible. Refined drug management and drug list: list all kinds of drugs being used in detail, including prescription drugs and over-the-counter drugs, to avoid mutual interference between drugs. Individualized adjustment of dosage: according to the status of renal function and the characteristics of drug metabolism, the dosage of drugs should be adjusted reasonably to prevent drug accumulation and toxic reactions. Electrocardiogram and imaging examination should be fully prepared before operation, and the state of cardiovascular and respiratory system should be comprehensively evaluated to ensure the safety of operation. Nutrition and water and electrolyte balance maintenance: ensure adequate water and electrolyte balance, prevent dehydration and electrolyte imbalance. Standard implementation of abstinence from food and drink: according to the guidance of medical experts, correctly implement the measures of abstinence from food and drink to ensure the smooth operation. Psychological counseling of psychological adjustment and family support: Elderly patients may have fear and anxiety in the face of surgery. In-depth communication with medical experts to understand the operation process and enhance confidence. Family companionship and encouragement: Family care and companionship are essential for the psychological support of elderly patients. 4. Key precautions in the process of anesthesia. In the process of anesthesia, medical experts will implement individualized anesthesia management according to the specific conditions of patients. Careful selection of anesthetic drugs: comprehensively consider the physiological changes of patients and the characteristics of drug metabolism, and select anesthetic drugs that have less impact on physiological functions. Close monitoring of vital signs: pay close attention to the patient’s blood pressure, heart rate, breathing and other vital signs to ensure the safety of the operation. Respiratory assistance and support: according to the actual needs, use mechanical ventilation or assisted ventilation equipment to ensure adequate oxygen supply and carbon dioxide discharge. 5. Postoperative rehabilitation and complications provention and control After surgery, elderly patients need more care and nursing. Effective pain management: use analgesic pump and individualized pain management program to relieve postoperative pain. Active prevention of complications: pay attention to the prevention of pulmonary infection, deep vein thrombosis and other complications, and keep the wound clean and dry. Nutritional science support: reasonable diet after surgery to promote wound healing and physical recovery. Carry out rehabilitation exercises in an orderly manner: according to the guidance of medical experts, carry out appropriate rehabilitation exercises to promote the recovery of physical function. The management of chronic diseases in elderly patients during preanesthesia is a complex and nuanced task. Through comprehensive assessment of the patient’s condition, drug management, preoperative preparation, psychological adjustment and individualized management during anesthesia, we can effectively reduce the risk of surgery and ensure the safety of surgery. At the same time, the provention and control of postoperative rehabilitation and complications can not be ignored, which requires the active cooperation of patients and their families.