Criteria for the assessment of anaesthesia among older patients
As global population ageing trends increase, the management of anaesthesia among older patients becomes an important issue in the medical field. The challenges and risks faced by older patients in the process of anaesthesia are more complex than those of younger patients and therefore require special care in pre-aesthesia assessments. The following are key criteria and concerns for anaesthesia assessment of older patients:
1. Detailed medical history and status assessment
Principle: To understand the overall health status of the patient in order to identify the potential risk of anaesthesia.
Implementation:
Chronic diseases: Many chronic diseases, such as hypertension, diabetes, heart disease, are common among older patients. These diseases may affect the metabolism of narcotic drugs and the safety of the surgical process. Control of these diseases and treatment programmes need to be assessed. Drug history: Understanding the drug use of patients, including prescription drugs, non-prescription drugs and complementary drugs, to identify possible drug interactions and potential adverse effects. Past history of anaesthesia: Ask patients about their past anaesthesia, including if there are adverse effects associated with anaesthesia, such as nausea, vomiting, confusion, etc., to help predict possible anaesthesia risks. 2. Physical and laboratory examinations
Principle: Assessment of the overall health of the patient and the resistance to anaesthesia through physical examination and laboratory tests.
Implementation:
Cardiac and pulmonary function assessment: conduct EKG, chest X-ray, heart ultrasound and lung function tests to understand the patient ‘ s CPR function. This is essential for the development of safe anaesthesia programmes. Hepatic and kidney function examination: assessment of the function of the liver and kidney (e.g. acetic anhydride, hepatic enzyme levels), as metabolism and excretion of narcotic drugs depend mainly on the function of these organs. Blood sugar level testing: Senior diabetes patients may need to pay special attention to blood sugar control to avoid complications during anaesthesia and surgery. Cognitive function and psychological assessment
Principle: Understanding the cognitive and psychological capacities of patients to assess post-operative recovery needs.
Implementation:
Cognitive function testing: assess the existence of cognitive impairments such as memory loss, confusion, etc. This is essential for the choice of narcotic drugs and for the development of post-operative care programmes. Psychological assessment: assesses the mental state of the patient, e.g. if he has symptoms of anxiety, depression, etc. Good management of mental health can help patients recover faster after surgery. Development of anaesthesia programme
Principle: Develop individualized anesthesia programmes based on the results of the assessment to ensure the safety of patients.
Implementation:
(b) The choice of anaesthesia: the most appropriate method of anaesthesia is chosen on the basis of the patient ‘ s state of health and type of operation. The choice of whole-body, regional or local anesthesia should take into account the overall health and surgical requirements of the patient. Drug dosage adjustment: Old-age patients usually need to adjust their drug dose to their drug sensitivity and metabolic capacity. Risk assessment and management: Identification of potential risks during surgery, such as heart events, respiratory problems, etc., and development of appropriate prevention and treatment measures. 5. Pre-operative preparation and post-operative care
Principle: Adequate pre-operative preparation and careful post-operative care help to reduce the risk of anaesthesia.
Implementation:
Pre-operative preparation: Pre-operative guidance, including dietary adjustment, medication, etc., to ensure that the patient is in good physical condition prior to the operation. Post-operative care: Develop detailed post-operative care plans, including pain management, cognitive function monitoring and rehabilitation support. Post-operative recovery for older patients is often slow and requires more care and support. Summary
The criteria for the assessment of older patients during anaesthesia include a detailed medical history and status assessment, a full physical and laboratory examination, cognitive function and psychological state assessment. Based on these findings, individualized anesthesia programmes, with adequate pre-operative preparation and intensive post-operative care, can effectively reduce the risk of anaesthesia and improve the safety and comfort of patients. Ensuring the safety of older patients during surgery and a smooth recovery from surgery is an important task in anaesthesia management.
