What should elderly patients pay attention to when receiving anesthesia?

In recent years, the average life expectancy in my country has continued to increase, and the number of elderly patients receiving surgical treatment has also increased significantly. Among them, surgery for elderly patients cannot be separated from the support of anesthesia. With the support of anesthesia, surgeons can effectively treat lesions. But unlike strong young people, surgical anesthesia for elderly patients is much more special. Because the body of a 70-year-old is not the same as that of a 30-year-old, more attention should be paid to surgical anesthesia. So, what should elderly patients pay attention to during surgery? Let's find out below!

1. Why are elderly patients special?

As an independent individual, no one can "reverse time" and return to a young state. Aging is a natural process for everyone, including elderly patients. Due to age, the organs of elderly patients will decline. This decline is not a decline of a single organ or system, but a holistic decline. Many elderly patients also have different chronic diseases.

Therefore, when undergoing the same surgery and anesthesia regimen, elderly patients are slower than young and middle-aged patients in terms of drug metabolism and anesthesia awakening, and elderly patients are more likely to suffer from cognitive impairment after receiving general anesthesia. At the same time, due to the influence of underlying diseases such as hypertension, elderly patients are more likely to encounter various risks during surgery. Therefore, elderly patients must be cautious when receiving anesthesia. Any carelessness may affect the safety and effectiveness of the operation. In the face of such a situation, special attention needs to be paid to the type of surgery, anesthesia regimen, and drug dosage, so as to ensure the safety of elderly patients to the greatest extent.

2. What should elderly patients pay attention to when receiving anesthesia?

2.1 Preoperative evaluation and preparation

When elderly patients need anesthesia, preoperative evaluation and preparation are particularly important. Usually, the anesthesiologist will visit before the operation begins, and then formulate the most scientific and reasonable anesthesia plan through comprehensive evaluation, and guide the clinic to control the underlying diseases, such as preoperative hypertension and hyperglycemia, which will increase the risk of surgery. Therefore, it is necessary to actively control blood pressure and blood sugar before the operation. For example, guide the clinic to use nifedipine to control blood pressure and insulin aspart to control blood sugar. Only after all indicators are stable can surgical treatment and anesthesia be performed.

It is well known that spinal anesthesia has ideal effects and fewer complications, so many elderly patients or their families hope to accept this anesthesia plan with fewer side effects. But in fact, the specific anesthesia method varies from person to person. Many elderly patients have problems such as spinal ligament degeneration, and some patients even have spondylitis, so the difficulty of spinal puncture will increase. In addition, elderly patients are more likely to suffer from hypotension during surgery after spinal anesthesia due to the decline in neuroregulatory function. Therefore, the pros and cons of the anesthesia plan cannot be judged from the surface, but must be determined in combination with one's own situation. In general, the anesthesiologist will fully combine the physical condition of the elderly patient to determine the final anesthesia plan to ensure the safety of the operation.

In addition, anesthesiologists will pay special attention to patients with low lung function and asthma. These conditions must be improved before anesthesia can be considered. In addition, patients with abnormal liver function, severe diabetes or kidney problems are not suitable for immediate anesthesia. What if the surgery must be done and cannot be delayed? Before anesthesia, the doctor needs to develop a detailed anesthesia plan based on the patient's specific situation, including various emergencies that may occur during the operation, to minimize the risk of anesthesia as much as possible.

For patients who are in poor physical condition, such as organ dysfunction and serious underlying diseases, they usually need to control their condition first and then receive care. Think about it, if a patient has severe dyslipidemia, must lipid-lowering treatment be performed before surgery? Yes, lipid-lowering treatment is necessary for such patients. Similarly, elderly patients with myocardial infarction often need to choose a more appropriate time for surgery to ensure that their physical condition can withstand the surgery. In this way, the risk of surgery can be minimized and the patient's safety can be better guaranteed.

2.2 Drug application before anesthesia

The choice of drugs before anesthesia is a big problem. So for elderly patients, what should be paid attention to before anesthesia? Generally speaking, elderly patients should try to avoid using analgesics with anesthetic properties before anesthesia. Even sedatives and hypnotic drugs should be used in reduced dosages according to the actual situation of the patient. Some people may ask, why is this so? Of course, it is because the body functions of elderly patients are relatively weak, and they may be more sensitive to drugs. Let’s talk about elderly patients with myocardial ischemia. Such patients must be more careful before surgery. Drugs such as atropine are not suitable for them. Because atropine may have a certain effect on the heart and increase the risk of surgery. Therefore, the use of drugs before anesthesia is really a big deal, and it must be carefully arranged according to the specific situation of the patient.

2.3 Choice of anesthesia method

In fact, no matter which anesthesia scheme or drug is chosen, it has its advantages and disadvantages. Therefore, it is still necessary to base it on the actual situation of the elderly patients, both to meet the surgical needs and to minimize the interference to the elderly patients' bodies.

Among them, the specific application of different anesthesia schemes depends on the patient's condition, the type of surgery, etc. General anesthesia does not equal "danger". On the contrary, some surgeries, such as knee replacement, still require general anesthesia. If conditions permit, anesthesiologists will give priority to anesthesia schemes with fewer side effects. Taking the anesthesia of elderly patients undergoing lower limb surgery as an example, if the patient has underlying diseases or organ dysfunction, anesthesiologists often use spinal anesthesia combined with epidural anesthesia based on the situation. This method of anesthesia has little effect on blood pressure and can better maintain the stability of the human circulatory system. For example, if elderly patients can only undergo general anesthesia, anesthesiologists may use intravenous anesthesia based on the situation. The postoperative recovery time of intravenous anesthesia is shorter and has less impact on the patient's cognitive function, so it is more appropriate to use it.

3. Conclusion

Generally speaking, there are many things that elderly patients need to pay attention to when receiving anesthesia. During this process, as family members or patients, we need to cooperate with the treatment and care of medical staff. The anesthesiologist will choose a suitable plan after our physiological condition stabilizes, so that the operation can proceed smoothly.

Author: Song Xi, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University