OSE_1306_part3_Layout 1 6/3/13 3:50 PM Page 135
ANESTHESIA ALERT
Did You Know?
Hepatic mass and blood
flow can decrease due to
cell loss. Consequently, geriatric patients are more likely
to experience prolonged
effects of opioids, benzodiazepines, local anesthetics
and neuromuscular-blocking
drugs.
atients who are 65 years or older
You may also see
undergo an estimated 15 million surgeries
decreased esophageal funcper year in the United States.
tion and gastric motility,
which can increase the risk of pulmonary aspiration in the perioperative period. Diabetic patients tend to digest food at a slower rate, and
that food carries a risk of traveling into the lungs. As far as metabolic
function goes, your geriatric patients are more likely to have insulin
resistance and/or impaired insulin secretion. Because about 10% of 50year-olds and 20% of 70-year-olds have diabetes, it's important to counsel your patients on how to take perioperative insulin and oral antihyperglycemics. It's a good idea to schedule these cases early to
decrease fasting times and hypoglycemic episodes.
Lastly, be aware of the increased risk of infections due to changes
in patients' immune functions, including pneumonia and urinary
tract and wound infections. These patients are likely to experience
decreased functional competence of NK cells, granulocytes,
macrophages and impaired phagocytosis. OSM
P
Dr. Singh-Radcliff (drninaradcliff@aol.com) is attending physician of the
department of anesthesiology and perioperative medicine at Atlanticare
Regional Medical Center in Pomona, N.J.
J U N E 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
1 3 5
