The society is getting older, and now we in thailand cannot escape this trend. According to the Nation Statistics Buereau, our kingdom is now an ageing society. Therefore, more ageing patients are expected to be the patients in the healthcare service all over the world, and anaesthetic considerations for these fragile population include many topics.
We can categorise the aged patient according to their chronological or their functional age, although some patients may look or appear to be healthy, however the organ function is less reserved in this healthy aged group.
First of all, the anatomical changes both the structure and function. These normal organ and overall function changes must be put together with planning anaethetics for them, although that is not considered as a disease or disorder. The skin is an obvious sign for all, the spines are osteoporotic, the vertebral column is collapsing making patient shorter than they were. Organ function, all decline after the age of 30, therefore, they cannot tolerate the tachycardia, the resting oxygen tension in blood is lower, the liver and kidney aggravate more pharmacokinetic changes, drug elimination is prolonged.
Secondly, they are likely to have pre-existing medical problems, especially diabetes and/or hypertension. That would make them receive preoperative medications; antihypertensives, hypoglycaemics, statins, etc. Some drugs would potentiate the anaesthetic drug effects making them prone to have perioperative complications.
Therefore when you have an aged patient in front of you, you do have to perform adequate preanaesthetic evaluation and preparation, choose the appropriate anaethetic technique, titrate the dose of planned given drugs to suit the patient's background, otherwise you would get mad after your patient develops a perioperative complication in the postanaesthesia care service area.
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