Prioritizing quality of life: Surgery, anesthesia considerations for elderly patients

Editor's Note

A March 11 article on SeniorLiving.org broke down key considerations and risks for elderly patients undergoing surgery and anesthesia. One such consideration is studies show that older adults often prioritize quality of life over the extension of life if it means sacrificing independence or functional abilities.

Other lessons highlighted by the article include:

• An estimated 4 million surgical procedures are performed annually on patients aged 65 and older, necessitating specialized care due to the age-related frailty and higher prevalence of chronic diseases.
• Preoperative evaluation is essential for determining the suitability of elderly patients for outpatient or inpatient surgeries, factoring in their medical history, comorbidities, and the potential need for postsurgical assistance.
• Age and comorbidities influence how patients react to anesthesia, necessitating a tailored approach to minimize risks such as postoperative cognitive dysfunction and delirium, which are more common in the elderly.
• Recommended preoperative testing includes electrocardiograms, metabolic panels, and blood counts, aimed at establishing baselines and assessing the patient's ability to tolerate anesthesia and surgery.
• Medication management is critical for avoiding complications in this more vulnerable patient population—in particular, specific instructions on managing existing medications prior to a surgical procedure can reduce risk.
• While rare, intraoperative awareness is a concern, with modern anesthetic practices and monitoring aiming to minimize its occurrence. Elderly patients, especially those with chronic pain or substance use histories, may require adjusted anesthetic dosages.

Elderly patients face an increased risk of complications that can significantly impact recovery and quality of life postoperatively. The increased surgical and anesthetic risks in the elderly population show the importance of comprehensive preoperative assessments, careful planning, and close postoperative monitoring to mitigate potential complications and ensure the best surgical outcomes for these patients.