Post by masders on Feb 15, 2024 9:44:29 GMT
World statistics show that one out of ten patients who need surgical intervention (especially non-cardiac) are over 70 years old, and 50% of surgical interventions are urgent. The most characteristic interventions that are performed in the adult population are various types of bypass surgery, hernia, cataract, bone replacement and many other operations. Anesthesia in adult patients Aging of systems and organs in the human body is an integral part of life. This process starts at birth and then accelerates in adulthood, during which changes are visible but often invisible over a longer period of time. Recent studies of some adults have classified them as "old" between the ages of 70 and 80, while patients older than 85 have been classified as "very old". Dr.
Marina Temellkovska Stevanovska, anesthesiologist, explains: "These people with physiological changes of aging are defined as "healthy old people", but usually, older people suffer from a large number of comorbidities. Not only do they have more risk factors for coronary artery disease, they are also more prone to cerebrovascular disease, peripheral artery disease, congestive heart failure, chronic heart disease, atrial Moldova Email List fibrillation, chronic obstructive disease. of the lungs, arthritis, dyslipidemia, hypertension, diabetes, dementia, etc. On the other hand, despite the greater prevalence of cardiovascular diseases, the effective therapy they use leads to a large reduction in absolute cardiovascular incidence." Determining the risk of intervention The purpose of the perioperative assessment of the patient is not to give medical permission for non-cardiological surgical intervention, but to evaluate the patient's current condition and give recommendations related to the risk of complications throughout the perioperative period.
In this way, the patient, the doctor, the anesthesiologist, the surgeon will be able to make decisions about the way of treatment that can affect the short-term and long-term results. Diagnostic tests should be used as they affect the treatment of the patient. In this group of patients, in addition to the history of drug therapy they use, as well as the standard diagnostic tests (lung X-ray, EKG and complete blood laboratory tests), other additional tests are often necessary, such as echo of the heart, stress test, spirometry, angiography, etc. - explains Dr. Stevanovska. Type of anesthesia If the surgical intervention is performed in the lower extremity or small pelvis, regional anesthesia (spinal or epidural) is preferred. "The choice between these two types of regional anesthesia usually depends on the expectation of postoperative pain.
Marina Temellkovska Stevanovska, anesthesiologist, explains: "These people with physiological changes of aging are defined as "healthy old people", but usually, older people suffer from a large number of comorbidities. Not only do they have more risk factors for coronary artery disease, they are also more prone to cerebrovascular disease, peripheral artery disease, congestive heart failure, chronic heart disease, atrial Moldova Email List fibrillation, chronic obstructive disease. of the lungs, arthritis, dyslipidemia, hypertension, diabetes, dementia, etc. On the other hand, despite the greater prevalence of cardiovascular diseases, the effective therapy they use leads to a large reduction in absolute cardiovascular incidence." Determining the risk of intervention The purpose of the perioperative assessment of the patient is not to give medical permission for non-cardiological surgical intervention, but to evaluate the patient's current condition and give recommendations related to the risk of complications throughout the perioperative period.
In this way, the patient, the doctor, the anesthesiologist, the surgeon will be able to make decisions about the way of treatment that can affect the short-term and long-term results. Diagnostic tests should be used as they affect the treatment of the patient. In this group of patients, in addition to the history of drug therapy they use, as well as the standard diagnostic tests (lung X-ray, EKG and complete blood laboratory tests), other additional tests are often necessary, such as echo of the heart, stress test, spirometry, angiography, etc. - explains Dr. Stevanovska. Type of anesthesia If the surgical intervention is performed in the lower extremity or small pelvis, regional anesthesia (spinal or epidural) is preferred. "The choice between these two types of regional anesthesia usually depends on the expectation of postoperative pain.