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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2015, Number 1

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An Med Asoc Med Hosp ABC 2015; 60 (1)

Anesthetic management in elderly patients over 95 years from 2005 to 2010: a retrospective study

Arriola CJ, Bernal BBC, Galaviz ODA, Cruz CG, Golzarri MM, Alejo GJA

Language: Spanish
References: 29
Page: 31-36
PDF size: 204.61 Kb.


ABSTRACT

Background: The global demographic trend is towards longevity. This demographic shift has had great impact in anesthetic practice, which eventually aims to establish a consensus on the management of these patients. The choice of technique and drug therapy is up to the skill and judgment of the anesthesiologist. Objective: To describe the anesthetic management, immediate evolution and hospital mortality in patients older than 95 years undergoing anesthetic and surgical procedures between the years 2005-2010. Methods: The files of patients 95 years and older were reviewed, collecting a total of 83; the following variables were considered: sex, age, ASA, duration of anesthesia, anesthetic technique and surgical specialty. All these, associated with the anesthetic management (sedation, general, regional and mixed anesthesia), evolution (room, recovery room, Intensive Care Unit and death) and mortality for descriptive purposes. Results: Of the 83 cases included, 51.5% were male and 48.2% female, aged between 95 and 105 years, with a median of 96. The predominant ASA was III (48.2% of the simple). Over 30% of patients had one or more chronic degenerative diseases. In terms of mortality (2.4%), no association between it and the age of the patients was found; however, a positive correlation between mortality and the technique of regional anesthesia was obtained. Conclusion: According to the literature, the overall morbidity and mortality in this age group is high; if we associate this to a surgical-anesthetic event, it is expected that this risk will increase. This study found that the majority of patients (94%) have adequate postoperative outcomes and low morbidity and mortality (6%). Regardless of age, ASA and surgical specialty, the constant in terms of anesthetic technique is the use of general anesthesia; this technique is not associated with increased mortality, but it is with morbidity. It is necessary to establish new lines of scientifically validated research for the elderly patient focusing on optimizing the anesthetic management.


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