Anaesthesia and the preparation and management of elderly patients undergoing surgery

With increasing life expectancy, the number of very elderly patients requiring surgery and anaesthesia is increasing. Age, co-morbidity and altered pharmacokinetics clearly need to be considered in assessment of surgical risk but even in the apparently well older person there is a loss of physiological reserve that may be overlooked on cursory examination. Cognitive impairment after surgery may seriously hinder older people. This paper looks at these factors in detail and provides some remedies.