Anesthesia for the Geriatric Patient

Question 1

How much do CO decrease after the age of 30?

Answer 1

1% per year after the age og 30

Pathophysiology of aging
• Cardiovascular system:
– Coronary flow decreases
– Heart rate decreases
– Response to stress decreases
– Peripheral vascular resistance and SBP increases
– Cardiac output decreases (by 1% per year after age 30)
– Adrenoreceptor sensitivity decreases
– Cardiac reserve decreases (EF does not increase w/
stress and may even decrease)
• Diastolic dysfunction present in ~ 50% of patients >65 with
diagnosis of CHF –> pulmonary edema with increased fluids

Question 2

Why are geriatric patients more reliant of vascular tone and preload?

Answer 2

Impaired beta receptor responsiveness limits ability to increase cardiac output by increasing HR –> makes patient more reliant to vascular tone and preload

Question 3

No mater what– this change happens to cardiac

Answer 3

Arterial Stiffening

Question 4

What are the effects of Anesthesia/ Surgery on Nervous system?

Answer 4

Question 5

What are the alterations in pain perception?

Answer 5

this is a bad thing

Question 6

What are the alterations in pulmonary system?

What can you do?

Answer 6

give patients large TV breaths at the end of the case especially with an LMA.

PS – switch to spontaneous, tighten your APL, HOLD THE bag!