Anesthesia for the Elderly Patient

Older surgical patients represent a challenge for the anesthesiologist, because aging induces a progressive loss of functional reserve in all organs and systems. Symptomatic comorbidities, treatment with multiple medications, and a reduced functional reserve make these patients more susceptible to anesthetic agents, and appropriate drug choice and tritation are required to achieve the desired clinical effect. Scientific evidence is insufficient to recommend a most appropriate anesthetic approach, and both the functional status of the patient and the type of surgery must be carefully considered, when selecting anesthetic drugs and techniques. Anesthesia-related complications are rare, especially when all the perioperative period has been planned in detail by the full team taking care of the patient: physician, surgeon, and anesthesiologist. After surgery, older adults are at high risk of cognitive impairments, such as delirium and decline in cognitive functions, and great care must be taken to identify patients at high risk for cognitive impairments with the goal of returning the elderly to baseline conditions.