Perioperative management of elderly and senile patients. Recommendations
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Keywords

elderly and senile patients
perioperative management
anesthesia
senile asthenia
nutritional insufficiency
cognitive impairment

How to Cite

Zabolotskikh IB, Gorobets ES, Grigoryev EV, Kotovskaya YV, Lebedinskii KM, Musaeva TS, Mkhitaryan EA, Ovechkin AM, Ostapenko VS, Rozanov AV, Runikhina NK, Tkacheva ON, Trembach NV, Khoronenko VE, Cherdak MA Perioperative management of elderly and senile patients. Recommendations. Annals of Critical Care. 2022;(3):7–26. doi:10.21320/1818-474X-2022-3-7-26.

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Abstract

Perioperative management of elderly patients remains one of the most difficult tasks of modern anesthesiology. Compared with younger patients, people over 60 years of age have a higher risk of developing adverse postoperative outcomes, as a result of age-related decline in physiological functions, the presence of several concomitant diseases, polypragmasia, cognitive dysfunction and specific geriatric syndromes, such as frailty. More than 25 % of this category of people have several chronic diseases of the cardiovascular, nervous, endocrine, hematopoietic, musculoskeletal systems, respiratory, digestive and other systems. In the process of aging, there is also a decrease and some perversion of metabolic processes, a decrease in the reactivity of the body. All of the above, along with the surgical intervention, increases the risk of postoperative complications and perioperative mortality.

The recommendations present the definition of the category of elderly and senile patients, provide information about age-related changes in their body that affect anesthesia and intensive care. The main clinical syndromes and symptoms useful in predicting the unfavorable course of the perioperative period are indicated, including frailty, nutritional insufficiency, sarcopenia and cognitive dysfunction. Methods for assessing functional activity and the risk of falls are given separately. Attention is paid to the causes, diagnosis, prevention and treatment of delirium, cardiovascular, respiratory complications. The principles of choosing the method of anesthesia and management of the perioperative period in elderly and senile patients, depending on the features of interventions and concomitant pathology, are described.

https://doi.org/10.21320/1818-474X-2022-3-7-26
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References

  1. Tosato M., Zamboni V., Ferrini A., Cesari M.The aging process and potential interventions to extend life expectancy. Clin. Interv. Aging. 2007; 2: 401–12.
  2. Weiser T.G., Regenbogen S.E., Thompson K.D., et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008; 372(9633): 139–44. DOI: 10.1016/S0140-6736(08)60878-8
  3. Monk T.G., Weldon B.C., Garvan C.W, et al. Predictors of cognitive dysfunction after major noncardiac surgery. Anesthesiology. 2008; 108: 18–30. DOI: 10.1097/01.anes.0000296071.19434.1e
  4. Брискин Б.С., Ломидзе О.В. Влияние полиморбидности на диагностику и исход в абдоминальной хирургии у пожилых. Клиническая геронтология. 2008; 4: 30–3. [Briskin B.S., Lomidze O.V. Effect of polymorbidity on diagnosis and outcome in abdominal surgery in the elderly. Klinicheskaya gerontologiya. 2008; 4: 30–3. (In Russ)]
  5. Федоровский Н.М. Физиологические особенности стареющего организма в оценке специалиста по анестезиологии, реаниматологии и интенсивной терапии. Клиническая геронтология. 2003; 2: 36–40. [Fedorovsky N.M. Physiological features of the aging organism in the evaluation of a specialist in anesthesiology, resuscitation and intensive care. Klinicheskaya gerontologiya. 2003; 2: 36–40 (In Russ)]
  6. Ghaferi A.A., Birkmeyer J.D., Dimick J.B. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009; 361(14): 1368–75. DOI: 10.1056/NEJMsa0903048
  7. Peters R.Ageing and the brain. Postgrad Med J 2006; 82: 84–8. DOI: 10.1136/pgmj.2005.03666515
  8. Borson S., Scanlan J., Brush M., et al. The mini-cog: a cognitive ’vital signsʼ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry. 2000; 15(11): 1021–7. DOI: 10.1002/1099-1166(200 011)15:11<1021::aid-gps234>3.0.co;2–6
  9. Tiwary N., Treggiari M.M., Yanez N.D., et al. Agreement Between the Mini-Cog in the Preoperative Clinic and on the Day of Surgery and Association With Postanesthesia Care Unit Delirium: A Cohort Study of Cognitive Screening in Older Adults. Anesth Analg. 2021; 132(4): 1112–9. DOI: 10.1213/ANE.0000000000005197
  10. Smith T., Pelpola K., Ball M., et al. Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis. Age Ageing. 2014; 43(4): 464–71. DOI: 10.1093/ageing/afu065
  11. Oresanya L.B., Lyons W.L., Finlayson E.Preoperative assessment of the older patient: a narrative review. JAMA. 2014; 311(20): 2110–20. DOI: 10.1001/jama.2014.4573
  12. Daniels A.H., Daiello L.A., Lareau C.R., et al. Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients. Am J Orthop (Belle Mead NJ). 2014; 43(7): E146–E152.
  13. Watt J., Tricco A.C., Talbot-Hamon C., Pham B.Identifying older adults at risk of harm following elective surgery: a systematic review and meta-analysis. BMC Med. 2018; 16(1): 2. DOI: 10.1186/s12916-017-0986-2.
  14. Chow W.B., Rosenthal R.A., Merkow R.P., et al. Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg. 2012; 215(4): 453–66. DOI: 10.1016/j.jamcollsurg.2012.06.017
  15. Robinson T.N., Raeburn C.D., Tran Z.V., et al. Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg. 2009; 249(1): 173–8. DOI: 10.1097/SLA.0b013e31818e4776
  16. Steiner L.A. Postoperative delirium guidelines: The greater the obstacle, the more glory in overcoming it. Eur J Anaesthesiol. 2017; 34(4): 189–91. DOI:1097/EJA.0000000000000578
  17. Inzitari M., Newman A.B., Yaffe K., et al. Gait speed predicts decline in attention and psychomotor speed in older adults: the health aging and body composition study. Neuroepidemiology. 2007; 29(3–4): 156–62. DOI: 10.1159/000111577
  18. Montero-Odasso M., Schapira M., Soriano E.R., et al. Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older. J Gerontol A Biol Sci Med Sci. 2005; 60(10): 1304–9. DOI: 10.1093/gerona/60.10.1304
  19. Shinkai S., Watanabe S., Kumagai S., et al. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing. 2000; 29(5): 441–6. DOI:1093/ageing/29.5.441
  20. Studenski S., Perera S., Patel K., et al. Gait speed and survival in older adults. JAMA. 2011; 305(1): 50–8. DOI: 10.1001/jama.2010.1923
  21. Mahoney F.I., Barthel D.W. Functional evaluation: the Barthel index. Md State Med J. 1965; 14: 61–5.
  22. Lawton M.P., Brody E.M. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9(3): 179–86.
  23. Bohannon R.W. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006; 29(2): 64–8. DOI: 10.1519/00139143-200608000-00004
  24. Shumway-Cook A., Brauer S., Woollacott M.Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000; 80: 896–903.
  25. Kristensen M.T., Foss N.B., Kehlet H. Timed “up & go” test as a predictor of falls within 6 months after hip fracture surgery [published correction appears in Phys Ther. 2007; 87(2): 227]. 2007; 87(1): 24–30. DOI: 10.2522/ptj.20050271
  26. Eagle D.J., Salama S., Whitman D., et al. Comparison of three instruments in predicting accidental falls in selected inpatients in a general teaching hospital. J Gerontol Nurs. 1999; 25(7): 40–5. DOI: 10.3928/0098-9134-19990701-14
  27. Van Grootven B., McNicoll L., Mendelson D.A., et al. Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study. BMJ Open. 2018; 8(3): e020617. Published 2018 Mar 16. DOI: 10.1136/bmjopen-2017-020617
  28. Guirguis-Blake J.M., Michael Y.L., Perdue L.A., et al. Interventions to Prevent Falls in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018; 319(16): 1705–16. DOI: 10.1001/jama.2017.21962
  29. Surkan M.J., Gibson W.Interventions to Mobilize Elderly Patients and Reduce Length of Hospital Stay. Can J Cardiol. 2018; 34(7): 881–8. DOI: 10.1016/j.cjca.2018.04.033
  30. Gutiérrez-Valencia M., Izquierdo M., Cesari M., et al. The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol. 2018; 84(7): 1432–44. DOI: 10.1111/bcp.13590
  31. Clegg A., Young J., Iliffe S., et al. Frailty in elderly people [published correction appears in Lancet. 2013; 382(9901): 1328]. Lancet. 2013; 381(9868): 752–62. DOI: 10.1016/S0140-6736(12)62167-9
  32. Buta B.J., Walston J.D., Godino J.G., et al. Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments. Ageing Res Rev. 2016; 26: 53–61. DOI: 10.1016/j.arr.2015.12.003
  33. Morley J.E., Arai H., Cao L., et al. Integrated Care: Enhancing the Role of the Primary Health Care Professional in Preventing Functional Decline: A Systematic Review. J Am Med Dir Assoc. 2017; 18(6): 489–94. DOI: 10.1016/j.jamda.2017.03.015
  34. Fried L.P., Tangen C.M., Walston J., et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3): M146–M156. DOI: 10.1093/gerona/56.3.m146
  35. Vermeiren S., Vella-Azzopardi R., Beckwée D., et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc. 2016; 17(12): 1163.e1–1163.e17. DOI: 10.1016/j.jamda.2016.09.010
  36. Syddall H., Cooper C., Martin F., et al. Is grip strength a useful single marker of frailty? Age Ageing. 2003; 32(6): 650–6. DOI: 10.1093/ageing/afg111
  37. Mitnitski A.B., Mogilner A.J., Rockwood K.Accumulation of deficits as a proxy measure of aging. Scientific World Journal. 2001; 1: 323–36. DOI: 10.1100/tsw.2001.58
  38. Ramani L., Furmedge D.S., Reddy S.P. Comprehensive geriatric assessment. Br J Hosp Med (Lond). 2014; 75(Suppl 8): C122–C125. DOI: 10.12968/hmed.2014.75.sup8.c122
  39. Turner G., Clegg A.; British Geriatrics Society; Age UK; Royal College of General Practioners. Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report. Age Ageing. 2014; 43(6): 744–7. DOI: 10.1093/ageing/afu138
  40. Rong A., Franco-Garcia E., Zhou C., et al. Association of nutrition status and hospital-acquired infections in older adult orthopedic trauma patients. JPEN J Parenter Enteral Nutr. 2021; 10.1002/jpen.2096. DOI: 10.1002/jpen.2096
  41. Zhao Y., Ge N., Xie D., et al. The geriatric nutrition risk index versus the mini-nutritional assessment short form in predicting postoperative delirium and hospital length of stay among older non-cardiac surgical patients: a prospective cohort study. BMC Geriatr. 2020; 20(1): 107. DOI: 10.1186/s12877-020-1501-8
  42. Li Z.E., Lu S.B., Kong C., et al. A prospective comparative study of the MNA-SF and GNRI nutritional screening tools in predicting infectious complications among elderly patients over 70 years undergoing posterior lumbar arthrodesis. Aging Clin Exp Res. 2021; 33(7): 1947–53. DOI: 10.1007/s40520-020-01725-7
  43. van Stijn M.F., Korkic-Halilovic I., Bakker M.S., et al. Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review. JPEN J Parenter Enteral Nutr. 2013; 37(1): 37–43. Epub 2012 May 1. DOI: 10.1177/0148607112445900
  44. Adogwa O., Elsamadicy A.A., Mehta A.I., et al. Preoperative Nutritional Status is an Independent Predictor of 30-day Hospital Readmission After Elective Spine Surgery. Spine (Phila Pa 1976). 2016; 41(17): 1400–4. DOI: 10.1097/BRS.0000000000001551
  45. Dupuis M., Kuczewski E., Villeneuve L., et al. Age Nutrition Chirugie (ANC) study: impact of a geriatric intervention on the screening and management of undernutrition in elderly patients operated on for colon cancer, a stepped wedge controlled trial. BMC Geriatr. 2017; 17(1): 10. DOI: 10.1186/s12877-016-0402-3
  46. Yang Y., Gao P., Chen X., et al. Prognostic significance of preoperative prognostic nutritional index in colorectal cancer: results from a retrospective cohort study and a meta-analysis. Oncotarget. 2016; 7(36): 58543–52. DOI: 10.18632/oncotarget.10148
  47. Sun Z., Kong X.J., Jing X., et al. Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. PLoS One. 2015; 10(7):e0132857. DOI: 10.1371/journal.pone.0132857. eCollection 2015.
  48. Braga M., Ljungqvist O., Soeters P. ESPEN Guidelines on Parenteral Nutrition: Surgery Clinical Nutrition. 2009; 28: 378–86. DOI: 10.1016/j.clnu.2009.04.002
  49. Hansen T., Nielsen R.L., Houlind M.B., et al. Dysphagia Prevalence, Time Course, and Association with Probable Sarcopenia, Inactivity, Malnutrition, and Disease Status in Older Patients Admitted to an Emergency Department: A Secondary Analysis of Cohort Study Data. Geriatrics (Basel). 2021; 6(2): 46. Published 2021 Apr 26. DOI: 10.3390/geriatrics6020046
  50. Miyashita T., Kikutani T., Nagashima K., et al. The effects of sarcopenic dysphagia on the dynamics of swallowing organs observed on videofluoroscopic swallowing studies. J Oral Rehabil. 2020; 47: 584–90. DOI: 10.1111/joor.12936
  51. Olesen M.D., Modlinski R.M., Poulsen S.H., et al. Prevalence of signs of dysphagia and associated risk factors in geriatric patients admitted to an acute medical unit. Nutr. ESPEN. 2021; 41: 208–16. DOI: 10.1016/j.clnesp.2020.12.020
  52. Byun S.E., Kwon K.B., Kim S.H., Lim S.J. The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea. BMC Geriatr. 2019; 19(1): 356. Published 2019 Dec 18. DOI: 10.1186/s12877-019-1382-x
  53. Baijens L.W., Clavé P., Cras P., et al. European Society for Swallowing Disorders — European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016; 11: 1403–28. Published 2016 Oct 7. DOI: 10.2147/CIA.S107750
  54. Soutome S., Yanamoto S., Funahara M., et al. Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery: A multicenter case-control study with propensity score matching analysis. Medicine (Baltimore). 2017; 96(33): e7436. DOI: 10.1097/MD.000000000000743
  55. Hirano Y., Takeuchi H., Suda K., et al. Clinical utility of the Revised Cardiac Risk Index in non-cardiac surgery for elderly patients: a prospective cohort study. Surg Today. 2014; 44(2): 277–84. DOI: 10.1007/s00595-013-0543-3
  56. Andersson C., Wissenberg M., Jørgensen M.E.Age-specific performance of the revised cardiac risk index for predicting cardiovascular risk in elective noncardiac surgery. Circ Cardiovasc Qual Outcomes. 2015; 8(1): 103–8. DOI: 10.1161/CIRCOUTCOMES.114.001298
  57. Snowdon D., Haines T.P., Skinner E.H.Preoperative intervention reduces postoperative pulmonary complications but not length of stay in cardiac surgical patients: a systematic review. J Physiother. 2014; 60(2): 66–77. DOI: 10.1016/j.jphys.2014.04.002
  58. Liu L.Y., Liu Z.J., Xu G.Y., et al. Clinical Utility of Revised Cardiac Risk Index to Predict Perioperative Cardiac Events in Elderly Patients with Coronary Heart Disease Undergoing Non-cardiac Surgery. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2020; 42(6): 732–9. DOI: 10.3881/j.issn.1000-503X.12635
  59. Canet J., Sabaté S., Mazo V.Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: A prospective, observational study. Eur J Anaesthesiol. 2015; 32(7): 458–70. DOI: 10.1097/EJA.0000000000000223
  60. Assessment of Ventilation during general AnesThesia for Robotic surgery (AVATaR) Study Investigators; PROtective VEntilation (PROVE) Network; Writing Committee Members; Steering Committee Members; AVATaR Investigators. Ventilation and outcomes following robotic-assisted abdominal surgery: an international, multicentre observational study. Br J Anaesth. 2021; 126(2): 533–43. DOI: 10.1016/j.bja.2020.08.058
  61. Patterson S.M., Cadogan C.A., Kerse N., et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014; 10: CD008165. DOI: 10.1002/14651858.CD008165.pub3
  62. Löffler C., Drewelow E., Paschka S.D., et al. Optimizing polypharmacy among elderly hospital patients with chronic diseases — study protocol of the cluster randomized controlled POLITE-RCT trial. Implement Sci. 2014; 9: 151. DOI: 10.1186/s13012-014-0151-7
  63. Milos V., Rekman E., Bondesson Å., et al. Improving the quality of pharmacotherapy in elderly primary care patients through medication reviews: a randomised controlled study. Drugs Aging. 2013; 30(4): 235–46. DOI: 10.1007/s40266-013-0057-0
  64. Walsh E.K., Cussen K. “Take ten minutes”: a dedicated ten minutes’ medication review reduces polypharmacy in the elderly. Ir Med J. 2010; 103(8): 236–8.
  65. Gallagher P.F., OʼConnor M.N., OʼMahony D. Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria. Clin Pharmacol Ther. 2011; 89(6): 845–54. DOI: 10.1038/clpt.2011.44
  66. Verwijmeren L., Peelen L.M., van Klei W.A., et al. Anaesthesia geriatric evaluation to guide patient selection for preoperative multidisciplinary team care in cardiac surgery. Br J Anaesth. 2020; S0007-0912(20)30014-3. DOI: 10.1016/j.bja.2019.12.042
  67. Ekstein M., Gavish D., Ezri T., Weinbroum A.A.Monitored anesthesia care in the elderly: guidelines and recommendations. Drugs and Aging. 2008; 25: 477–500.
  68. Sessler D.I., Sigl J.C., Kelley S.D., et al. Hospital stay and mortality are increased in patients having a “triple low” of low blood pressure, low bispectral index, and low minimum alveolar concentration of volatile anesthesia. 2012; 116: 1195–203. DOI: 10.1097/ALN.0b013e31825683dc
  69. Pietraszewski P., Gaszynski T.Residual neuromuscular block in elderly patients after surgical procedures under general anesthesia with rocuronium. Anesthesiology Intensive Therapy. 2013; 45: 77–81. DOI: 10.5603/AIT.2013.0017
  70. Klose P., Lorenzen U., Berndt R., et al. Continuous noninvasive monitoring of arterial pressure using the vascular unloading technique in comparison to the invasive gold standard in elderly comorbid patients: A prospective observational study. Health Sci Rep. 2020 Nov 10; 3(4): e204. DOI: 10.1002/hsr2.204
  71. Eichhorn J.H., Cooper J.B., Cullen D.J., et al. Standards for patient monitoring during anesthesia at Harvard Medical School. 1986; 29; 256(8): 1017–20.
  72. Walsh M., Devereaux P.J., Garg A.X., et al. Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension. 2013; 119: 507–15. DOI: 10.1097/ALN.0b013e3182a10e26
  73. Marik P.E., Baram M., Vahid B.Does central venous pressure predict fluid responsiveness? A systematic review of the literature and the tale of seven mares. 2008; 134: 172–8. DOI: 10.1378/chest.07-2331
  74. Sieber F.E., Barnett S.R.Preventing postoperative complications in the elderly. Anesthesiology Clinics. 2011; 29: 83–97. DOI: 10.1016/j.anclin.2010.11.011
  75. Naylor A.J., Sessler D.I., Maheshwari K., et al. Arterial Catheters for Early Detection and Treatment of Hypotension During Major Noncardiac Surgery: A Randomized Trial. Anesth Analg. 2020; 131(5): 1540–50. DOI: 10.1213/ANE.0000000000004370
  76. Takagi S., Sugaya N., Kiuchi N., et al. High-dose rocuronium-induced paralysis of the adductor pollicis muscle facilitates detection of the timing for tracheal intubation in elderly patients: a randomized double-blind study. J Anesth. 2020; 34(6): 876–80. DOI: 10.1007/s00540-020-02831-6
  77. Santos F.N.C., Braga A.F.A., Ribeiro C.J.B.L., et al. Use of protocol and evaluation of postoperative residual curarization incidence in the absence of intraoperative acceleromyography — Randomized clinical trial. Rev Bras Anestesiol. 2017; 67(6): 592–9. DOI: 10.1016/j.bjan.2017.02.006
  78. Shan W., Chen B., Huang L., Zhou Y.The Effects of Bispectral Index-Guided Anesthesia on Postoperative Delirium in Elderly Patients: A Systematic Review and Meta-Analysis. World Neurosurg. 2020: S1878-8750(20)32495- DOI: 10.1016/j.wneu.2020.11.110
  79. Stammet P., Collignon O., Werer C., et al.Bispectral index to predict neurological outcome early after cardiac arrest. 2014; 85(12): 1674–80. DOI: 10.1016/j.resuscitation.2014.09.009
  80. Selig C., Riegger C., Dirks B., et al. Bispectral index (BIS) and suppression ratio (SR) as an early predictor of unfavourable neurological outcome after cardiac arrest. 2014; 85(2): 221–6. DOI: 10.1016/j.resuscitation.2013.11.008
  81. Reynolds L., Beckman J., Kurz A.Peri-operative complications of hypothermia. Best Practice and Research, Clinical Anesthesiology. 2008; 22: 645–57. DOI: 1016/j.bpa.2008.07.005
  82. Zhang R., Chen X., Xiao Y.The effects of a forced-air warming system plus electric blanket for elderly patients undergoing transurethral resection of the prostate: A randomized controlled trial. Medicine (Baltimore). 2018; 97(45): DOI: 10.1097/MD.0000000000013119
  83. Ma H., Lai B., Dong S., et al. Warming infusion improves perioperative outcomes of elderly patients who underwent bilateral hip replacement. Medicine (Baltimore). 2017; 96(13): e6490. DOI: 10.1097/MD.0000000000006490
  84. Jo Y.Y., Chang Y.J., Kim Y.B., et al. Effect of Preoperative Forced-Air Warming on Hypothermia in Elderly Patients Undergoing Transurethral Resection of the Prostate. Urol J. 2015; 12(5): 2366–70.
  85. Deren M.E., Machan J.T., DiGiovanni C.W., et al. Prewarming operating rooms for prevention of intraoperative hypothermia during total knee and hip arthroplasties. J Arthroplasty. 2011; 26(8): 1380–6. DOI: 10.1016/j.arth.2010.12.019
  86. Ozaki M., Sessler D.I., Matsukawa T., et al. The threshold for thermoregulatory vasoconstriction during nitrous oxide/sevoflurane anesthesia is reduced in the elderly. Anesth Analg. 1997; 84(5): 1029–33. DOI: 10.1097/00000539-199705000-00014
  87. Schofield P. The assessment and management of perioperative pain in older people. 2014; 69(Suppl. 1): 54–60. DOI: 10.1111/anae.12520
  88. Kruijt Spanjer M.R., Bakker N.A., Absalom A.R.Pharmacology in the elderly and newer anesthesia drugs. Best Practice and Research: Clinical Anesthesiology. 2011; 25: 355–65. DOI: 10.1016/j.bpa.2011.06.002
  89. Nickalls R.W., Mapleson W.W. Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane in man. Br J Anaesth. 2003; 91(2): 170–4. DOI: 10.1093/bja/aeg132
  90. Vuyk J., Lichtenbelt B.J., Olofsen E., et al. Mixed-effects modeling of the influence of midazolam on propofol pharmacokinetics. Anesth Analg. 2009; 108: 1522–30. DOI: 10.1213/ane.0b013e31819e4058
  91. Smith C., McEwan A.I., Jhaveri R., et al. The interaction of fentanyl on the Cp50 of propofol for loss of consciousness and skin incision. 1994; 81: 820–8.
  92. Cressey D.M., Claydon P., Bhaskaran N.C., et al. Effect of midazolam pretreatment on induction dose requirements of propofol in combination with fentanyl in younger and older adults. 2001; 56: 108–13. DOI: 10.1046/j.1365-2044.2001.01789.x
  93. Rooke G.A.Cardiovascular aging and anesthetic implications. J Cardiothorac Vasc Anesth. 2003; 17: 512–23. DOI: 10.1016/S1053-0770(03)00161-7
  94. Reich D.L., Hossain S., Krol M., et al. Predictors of hypotension after induction of general anesthesia. Anesth Analg. 2005; 101: 622–8. DOI: 10.1213/01.ANE.0000175214.38450.91
  95. Schultz A., Grouven U., Zander I., et al.Age-related effects in the EEG during propofol anaesthesia. Acta Anaesthesiol Scand. 2004; 48(1): 27–34. DOI: 10.1111/j.1399-6576.2004.00258.x
  96. Kazama T., Ikeda K., Morita K., et al. Comparison of the effect-site k(eO)s of propofol for blood pressure and EEG bispectral index in elderly and younger patients. 1999; 90(6): 1517–27. DOI: 10.1097/00000542-199906000-00004
  97. Jacobs J.R., Reves J.G., Marty J., et al. Aging increases pharmacodynamic sensitivity to the hypnotic effects of midazolam. Anesth Analg. 1995; 80(1): 143–8. DOI: 10.1097/00000539-199501000-00024
  98. Barr J., Fraser G.L., Puntillo K., et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013; 41: 263–306. DOI: 10.1097/CCM.0b013e3182783b72
  99. Cepeda M.S., Farrar J.T., Baumgarten M., et al. Side effects of opioids during short-term administration: effect of age, gender, and race. Clin Pharmacol Ther. 2003; 74: 102–12. DOI: 10.1016/S0009-9236(03)00152-8
  100. Cedborg A.I., Sundman E., Boden K., et al. Pharyngeal function and breathing pattern during partial neuromuscular block in the elderly: effects on airway protection. 2014; 120: 312–25. DOI: 10.1097/ALN.0000000000000043
  101. Ornstein E., Lien C.A., Matteo R.S., et al. Pharmacodynamics and pharmacokinetics of cisatracurium in geriatric surgical patients. 1996; 84(3): 520–5. DOI: 10.1097/00000542-199603000-00005
  102. McDonagh D.L., Benedict P.E., Kovac A.L., et al. Efficacy, safety, and pharmacokinetics of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in elderly patients. 2011; 114(2): 318–29. DOI: 10.1097/ALN.0b013e3182065c36
  103. Togioka B.M., Yanez D., Aziz M.F., et al. Randomised controlled trial of sugammadex or neostigmine for reversal of neuromuscular block on the incidence of pulmonary complications in older adults undergoing prolonged surgery. Br J Anaesth. 2020; 124(5): 553–61. DOI: 10.1016/j.bja.2020.01.016
  104. Kristensen S.D., Knuuti J., Saraste A., et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur J Anaesthesiol. 2014; 31(10): 517–73. DOI: 10.1097/EJA.0000000000000150
  105. Gelman S. Is norepinephrine infusion during intraoperative period justified? 2014; 121(2): 433–4. DOI: 10.1097/ALN.0000000000000322
  106. Wu W.C., Smith T.S., Henderson W.G., et al. Operative blood loss, blood transfusion, and 30-day mortality in older patients after major noncardiac surgery. Annals of Surgery. 2010; 252: 11–7. DOI: 10.1097/SLA.0b013e3181e3e43f
  107. Brandstrup B., Svendsen P.E., Rasmussen M., et al. Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance? Br J Anaesth. 2012; 109(2): 191–9. DOI: 10.1093/bja/aes163. Epub 2012 Jun 17.
  108. Scheeren T.W., Wiesenack C., Gerlach H., Marx G.Goal-directed intraoperative fluid therapy guided by stroke volume and its variation in high-risk surgical patients: a prospective randomized multicentre study. J Clin Monit Comput. 2013; 27(3): 225–33. DOI: 10.1007/s10877-013-9461-6.
  109. Kapoor P.M., Magoon R., Rawat R., Mehta Y.Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”. Ann Card Anaesth. 2016; 19(4): 638–82. DOI: 10.4103/0971-191552
  110. Bartha E., Davidson T., Brodtkorb T.H., et al. Value of information: interim analysis of a randomized, controlled trial of goal-directed hemodynamic treatment for aged patients. 2013; 14: 205. DOI: 10.1186/1745-6215-14-205
  111. Soreide E., Eriksson L.I., Hirlekar G., et al. Preoperative fasting guidelines: an update (review). Acta Anaesthesiol Scand. 2005; 49: 1041–7. DOI: 10.1111/j.1399-6576.2005.00781.x
  112. Kristensen S.D., Knuuti J., Saraste A., et al. 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014; 35(35): 2383–431. DOI: 10.1093/eurheartj/ehu282
  113. Partridge J., Harari D., Martin F., Dhesi J.The impact of preoperative comprehensive geriatric assessment on postoperative outcomes in older patients undergoing scheduled surgery: a systematic review. 2014; 69(Suppl. 1): 8–16. DOI: 10.1111/anae.12494
  114. Keats A.S. Anesthesia mortality — a new mechanism. 1988; 68(1): 2–4.
  115. Keats A.S. Anesthesia mortality in perspective. Anesth Analg. 1990; 71(2): 113–9.
  116. Asher M.E. Surgical considerations in the elderly. J Perianesth Nurs. 2004; 19(6): 406–14. DOI: 10.1016/j.jopan.2004.08.003
  117. Mamaril M.E. Nursing considerations in the geriatric surgical patient: the perioperative continuum of care. Nurs Clin North Am. 2006; 41(2): 313-vii. DOI: 10.1016/j.cnur.2006.01.001
  118. Rosenfeld B.A., Beattie C., Christopherson R., et al. The effects of different anesthetic regimens on fibrinolysis and the development of postoperative arterial thrombosis. Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology. 1993; 79(3): 435–43. DOI: 10.1097/00000542-199309000-00005
  119. Shir Y., Raja S.N., Frank S.M., Brendler C.B.Intraoperative blood loss during radical retropubic prostatectomy: Epidural versus general anesthesia. 1995; 45: 993–9. DOI: 10.1016/S0090-4295(99)80120-4
  120. Memtsoudis S.G., Sun X., Chiu Y.L., et al. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. 2013; 118: 1046–58. DOI: 10.1097/ALN.0b013e318286061d
  121. Tsui B.C., Wagner A., Finucane B.Regional anaesthesia in the elderly: a clinical guide. Drugs Aging. 2004; 21(14): 895–910. DOI: 10.2165/00002512-200421140-00001
  122. Hersh E., Moore P.Drug interactions in dentistry. J Am Dent Assoc. 2004; 136: 298–311. DOI: 10.14219/jada.archive.2004.0178
  123. Tsui B.C., Wagner A., Finucane B.Regional anaesthesia in the elderly: a clinical guide. Drugs Aging. 2004; 21(14): 895–910. DOI: 10.2165/00002512-200421140-00001
  124. Li C., Friedman B., Conwell Y., Fiscella K.Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people. J Am Geriatr Soc. 2007; 55: 596–602. DOI: 10.1111/j.1532-5415.2007.01103.x
  125. Cheema S., Richardson J., McGurgan P.Factors affecting the spread of bupivacaine in the adult thoracic paravertebral space. 2003; 58(7): 684–7. DOI: 10.1046/j.1365-2044.2003.03189_1.x
  126. Hanks R.K., Pietrobon R., Nielsen K.C., et al. The effect of age on sciatic nerve block duration. Anesth Analg. 2006; 102(2): 588–92. DOI: 10.1213/01.ane.0000189552.85175.db
  127. Paqueron X., Boccara G., Bendahou M., et al.Brachial plexus nerve block exhibits prolonged duration in the elderly. 2002; 97(5): 1245–9. DOI: 10.1097/00000542-200211000-00030
  128. Chen D.X., Yang L., Ding L., et al. Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques: A systematic review and meta-analysis. Medicine (Baltimore). 2019; 98(49): e18220. DOI: 10.1097/MD.0000000000018220
  129. Guay J., Parker M.J., Griffiths R., Kopp S.Peripheral nerve blocks for hip fractures.Cochrane Database Syst Rev. 2017; 5(5): CD001159. DOI: 10.1002/14651858.CD001159.pub2
  130. Messina A., Frassanito L., Colombo D., et al. Hemodynamic changes associated with spinal and general anesthesia for hip fracture surgery in severe ASA III elderly population: a pilot trial. Minerva Anestesiol. 2013; 79(9): 1021–9.
  131. Guay J., Parker M.J., Gajendragadkar P.R., Kopp S.Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2016; 2: DOI: 10.1002/14651858.CD000521.pub3
  132. Guay J., Parker M.J., Griffiths R., Kopp S.Peripheral nerve blocks for hip fractures. Cochrane Database Syst Rev. 2017; 5: DOI: 10.1002/14651858.CD001159.pub2
  133. Guay J., Johnson R.L., Kopp S.Nerve blocks or no nerve blocks for pain control after elective hip replacement (arthroplasty) surgery in adults. Cochrane Database Syst Rev. 2017; 10: DOI: 10.1002/14651858.CD011608.pub2
  134. Chen D.X., Yang L., Ding L., et al. Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques: A systematic review and meta-analysis. Medicine (Baltimore). 2019; 98(49): e18220. DOI: 10.1097/MD.0000000000018220
  135. Vaurio L.E., Sands L.P., Wang Y., et al. Postoperative delirium: the importance of pain and pain management. Anesthesia and Analgesia. 2006; 102: 1267–73. DOI: 10.1213/01.ane.0000199156.59226.af
  136. Aubrun F.Management of postoperative analgesia in elderly patients. Reg Anesth Pain Med. 2005; 30(4): 363–79. DOI: 10.1016/j.rapm.2005.02.006
  137. Falzone E., Hoffmann C., Keita H.Postoperative analgesia in elderly patients. Drugs and Aging. 2013; 30: 81–90. DOI: 10.1007/s40266-012-0047-7
  138. Abdulla A., Adams N., Bone M., et al. Guidance on the management of pain in older people. Age and Ageing. 2013; 42(Suppl. 1): i1–42. DOI: 10.1093/ageing/afs200
  139. Apfel C.C., Turan A., Souza K., et al. Intravenous acetaminophen reduces postoperative nausea and vomiting: a systematic review and meta-analysis. 2013; 154(5): 677–89. DOI: 10.1016/j.pain.2012.12.025
  140. Anzone A.G.Current Challenges in Pain Management in Hip Fracture Patients. J Orthop Trauma. 2016; 30 Suppl 1: S1–5. DOI: 10.1097/BOT.0000000000000562
  141. Kang H., Ha Y.C., Kim J.Y., et al. Effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture: a randomized, controlled study. J Bone Joint Surg Am. 2013; 95(4): 291–6. DOI: 10.2106/JBJS.K.01708
  142. Kristek G ., Radoš I., Kristek D., et al. Influence of postoperative analgesia on systemic inflammatory response and postoperative cognitive dysfunction after femoral fractures surgery: a randomized controlled trial. Reg Anesth Pain Med. 2019; 44(1): 59–68. DOI: 10.1136/rapm-2018-000023
  143. Qin M., Chen K., Liu T., Shen X.Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy. BMC Anesthesiol. 2017; 17(1): 66. DOI: 10.1186/s12871-017-0363-x
  144. Barr J., Pandharipande P.P. The pain, agitation, and delirium care bundle: synergistic benefits of implementing the 2013 Pain, Agitation, and Delirium Guidelines in an integrated and interdisciplinary fashion. Crit Care Med. 2013; 41(9 Suppl 1): S99– DOI: 10.1097/CCM.0b013e3182a16ff0
  145. Sauaia A., Min S.J., Leber C., et al. Postoperative pain management in elderly patients: correlation between adherence to treatment guidelines and patient satisfaction. Journal of the American Geriatrics Society. 2005; 53: 274–82. DOI: 10.1111/j.1532-5415.2005.53114.x
  146. Bekker A.Y., Weeks E.J. Cognitive function after anaesthesia in the elderly. Best Pract Res Clin Anaesthesiol. 2003; 17(2): 259–72. DOI: 10.1016/s1521-6896(03)00005-3
  147. Silbert B., Evered L., Scott D.A. Cognitive decline in the elderly: is anaesthesia implicated? Best Pract Res Clin Anaesthesiol. 2011; 25(3): 379–93. DOI: 10.1016/j.bpa.2011.05.001
  148. Janssen T.L., Alberts A.R., Hooft L., et al. Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and meta-analysis. Clin Interv Aging. 2019; 14: 1095–117. DOI: 10.2147/CIA.S201323
  149. Olin K., Eriksdotter-Jönhagen M., Jansson A., et al.Postoperative delirium in elderly patients after major abdominal surgery. Br J Surg. 2005; 92(12): 1559–64. DOI: 10.1002/bjs.5053
  150. Radtke F.M., Franck M., Schneider M., et al. Comparison of three scores to screen for delirium in the recovery room. Br J Anaesth. 2008; 101(3): 338–43. DOI: 10.1093/bja/aen193
  151. Ely E.W., Margolin R., Francis J., et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001; 29(7): 1370–9. DOI: 10.1097/00003246-200107000-00012
  152. Inouye S.K., van Dyck C.H., Alessi C.A., et al. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990; 113(12): 941–8. DOI: 10.7326/0003-4819-113-12-941
  153. Gaudreau J.D., Gagnon P., Harel F., et al. Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale. J Pain Symptom Manage. 2005; 29(4): 368–75. DOI: 10.1016/j.jpainsymman.2004.07.009
  154. Dodds C., Foo I., Jones K., et al. Perioperative care of elderly patients — an urgent need for change: a consensus statement to provide guidance for specialist and non-specialist anaesthetists. Perioperative Medicine. 2013; 2: 6–11. DOI: 10.1186/2047-0525-2-6
  155. Clegg A., Young J.B.Which medications to avoid in people at risk of delirium: a systematic review. Age and Ageing. 2011; 40: 23–9. DOI: 10.1093/ageing/afq140
  156. Chew M.L., Mulsant B.H., Pollock B.G., et al. Anticholinergic activity of 107 medications commonly used by older adults. Journal of the American Geriatrics Society. 2008; 56: 1333–41. DOI: 10.1111/j.1532-5415.2008.01737.x
  157. Aldecoa C., Bettelli G., Bilotta F., et al. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017; 34(4): 192–214. DOI: 10.1097/EJA.0000000000000594
  158. Yoon H.J., Park K.M., Choi W.J., et al. Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium. BMC Psychiatry. 2013; 13: 240. Published 2013 Sep 30. DOI: 10.1186/1471-244X-13-240
  159. Hatta K., Kishi Y., Wada K,. et al. Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study. Int J Geriatr Psychiatry. 2014; 29(3): 253–62. DOI: 10.1002/gps.3999
  160. Qiao Y., Feng H., Zhao T., et al.Postoperative cognitive dysfunction after inhalational anesthesia in elderly patients undergoing major surgery: the influence of anesthetic technique, cerebral injury and systemic inflammation. BMC Anesthesiol. 2015; 15: 154. Published 2015 Oct 23. DOI: 10.1186/s12871-015-0130-9
  161. Lifshitz M., Dwolatzky T., Press Y.Validation of the Hebrew version of the MoCA test as a screening instrument for the early detection of mild cognitive impairment in elderly individuals. J Geriatr Psychiatry Neurol. 2012; 25(3): 155–61. DOI: 10.1177/0891988712457047
  162. Ciesielska N., Sokołowski R., Mazur E., et al. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol. 2016; 50(5): 1039–52. DOI: 10.12740/PP/45368
  163. Mathew J.P., Mackensen G.B., Phillips-Bute B., et al. Randomized, double-blinded, placebo controlled study of neuroprotection with lidocaine in cardiac surgery. 2009; 40(3): 880–7. DOI: 10.1161/STROKEAHA.108.531236
  164. Mathew J.P., White W.D., Schinderle D.B., et al. Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery. 2013; 44(12): 3407–13. DOI: 10.1161/STROKEAHA.113.002703
  165. Hudetz J.A., Iqbal Z., Gandhi S.D., et al. Ketamine attenuates post-operative cognitive dysfunction after cardiac surgery. Acta Anaesthesiol Scand. 2009; 53(7): 864–72. DOI: 10.1111/j.1399-6576.2009.01978.x
  166. Ottens T.H., Dieleman J.M., Sauër A.M., et al. Effects of dexamethasone on cognitive decline after cardiac surgery: a randomized clinical trial. Anesthesiology. 2014; 121(3): 492–500. DOI: 10.1097/ALN.0000000000000336
  167. Hudetz J.A., Patterson K.M., Iqbal Z., et al. Remote ischemic preconditioning prevents deterioration of short-term postoperative cognitive function after cardiac surgery using cardiopulmonary bypass: results of a pilot investigation. J Cardiothorac Vasc Anesth. 2015; 29(2): 382–8. DOI: 10.1053/j.jvca.2014.07.012
  168. Ballard C., Jones E., Gauge N., et al. Optimised anaesthesia to reduce post operative cognitive decline (POCD) in older patients undergoing elective surgery, a randomised controlled trial [published correction appears in PLoS One. 2012; 7(9). DOI: 10.1371/annotation/1cc38e55-23e8-44a5-ac2b-43c7b2a880f9. Amaoko, Derek [corrected to Amoako, Derek]] [published correction appears in PLoS One. 2013; 8(9). DOI: 10.1371/annotation/c0569644-bea1-4c38-af9a-75d1168e3142]. PLoS One. 2012; 7(6): e37410. DOI: 10.1371/journal.pone.0037410
  169. Wang F., Hou M.X., Wu X.L., et al. Impact of enteral nutrition on postoperative immune function and nutritional status. Genet Mol Res. 2015; 14(2): 6065–72. DOI: 10.4238/2015.June.8.4
  170. Boelens P.G., Heesakkers F.F., Luyer M.D., et al. Reduction of postoperative ileus by early enteral nutrition in patients undergoing major rectal surgery: prospective, randomized, controlled trial. Ann Surg. 2014; 259(4): 649–55. DOI: 10.1097/SLA.0000000000000288
  171. Liu Z.H., Su G.Q., Zhang S.Y., et al. Zhonghua Wei Chang Wai Ke Za Zhi. 2013; 16(11): 1063–6.
  172. Wyers C.E., Reijven P.L.M., Breedveld-Peters J.J.L., et al. Efficacy of Nutritional Intervention in Elderly After Hip Fracture: A Multicenter Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci. 2018; 73(10): 1429–37. DOI: 10.1093/gerona/gly030
  173. Wheble G.A., Knight W.R., Khan O.A. Enteral vs total parenteral nutrition following major upper gastrointestinal surgery. Int J Surg. 2012; 10(4): 194–7. DOI: 10.1016/j.ijsu.2012.02.015
  174. Lim S.F., Ong S.Y., Tan Y.L., et al. Incidence and predictors of new-onset constipation during acute hospitalisation after stroke. Int J Clin Pract. 2015; 69(4): 422–8. DOI: 10.1111/ijcp.12528
  175. Mari A., Mahamid M., Amara H., et al. Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management. Korean J Fam Med. 2020; 41(3): 139–45. DOI: 10.4082/kjfm.18.0182
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