Perioperative management of geriatric patients. Project of clinical recommendations

I.B. Zabolotskikh1, E.S. Gorobets2 E.V. Grigoriev3, I.A. Kozlov4, K.M. Lebedinsky5, T.S. Musaeva1, A.M. Ovechkin6, N.V. Trembach1, V.E. Khoronenko6

1 Federal State Budgetary Educational Institution for Higher Education «Kuban State Medical University» of the Ministry of Healthcare of the Russian Federation, Krasnodar

2 Blokhin Russian Cancer Research Centre, Moscow

3 Federal State Budgetary Educational Institution for Higher Education “Kemerovo State Medical University” of the Ministry of Healthcare of the Russian Federation, Kemerovo

4 Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy (“MONIKI”), Moscow

5 State budget institution of higher education “North-Western State Medical University named after I.I. Mechnikov” under the Ministry of Public Health of the Russian Federation, Saint-Petersburg

6 Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow

For correspondence: Igor B. Zabolotskikh — Doctor of Med. Sci., professor, head of the Department of Anesthesiology, Reanimatology and Transfusiology of the Kuban State Medical University; e-mail: pobeda_zib@mail.ru

For citation: Zabolotskikh IB, Gorobets ES, Grigoriev EV, et al. Perioperative Management of Geriatric Patients. Project of Clinical Recommendations. Alexander Saltanov Intensive Care Herald. 2018;1:60–74.

DOI: 10.21320/1818-474X-2018-1-60-74


The need for surgical treatment in elderly patients arises four times more often than the population average. Due to the tendency to increase life expectancy, the number of elderly patients who underwent surgery increases, which requires an increase in the geriatric care, including surgical and anesthetic care. It is well known that in comparison with young patients, older subjects have a higher risk of developing adverse postoperative outcomes as a result of age-related decline in physiological functions, the presence of several comorbidities, polypharmacy, cognitive dysfunction and specific geriatric syndromes such as frailty. The presented recommendations generalize modern principles of perioperative management in patients of older age groups. Particular attention is paid to the peculiarities of preoperative examination, including the evaluation of geriatric syndromes, the choice of anesthesia method and the correct calculation of doses of drugs for anesthesia. Great importance at the present time made the role of cognitive status of older patients and post-operative cognitive dysfunction, which substantially affects the outcome of the disease. These recommendations include measures to assess cognitive status and prevent complications associated with cognitive impairment. Individualization of approach to management of geriatric patients is the basis of effective prevention of perioperative complications.

Keywords: geriatrics, anesthesia, perioperative period

Received: 12.03.2018


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