Geriatric Anesthesia: A Practical Guide is a comprehensive reference on geriatric anesthesia. The book is divided into three sections. The first section covers the basics of both anatomical and physiological changes in senescence, and important polypharmacy considerations common in elderly patients. The next section covers anesthesia for cardiac and non-surgical patients. Various controversies and legal ethical issues that are particularly significant in the elderly such as advance directives, code status discussions, specific patient groups and shared decision-making prior to surgical interventions, are covered in the final section.
Key Features
- 20 referenced chapters covering basic geriatric anesthesia considerations, cardiac and non-surgical patients and special topics, respectively
- Contributions and references from experienced anesthesiologists
- Emphasis on tailoring perioperative management depending on specific circumstances of patients
- Addresses novel and commonly overlooked topics related to the geriatric population
Readership
Anesthesia providers and non-anesthesia medical providers, trainees and students.Table of Contents
Chapter 1 General Information- Andrea Villa and Bharathi Gourkanti
- Introduction
- Demographic Transition
- Stage1: High-Level Equilibrium
- Stage 2: Early Expansion
- Stage 3: Late Expansion
- Stage 4: Low-Level Equilibrium
- Comparison With the General Population
- Common Surgeries Among the Geriatric Population
- Mechanics of Aging
- Healthcare Costs Among Geriatric Population
- Conclusion
- References
- Magdy Takla, Michele Mele and Tina Takla
- Introduction
- Central Nervous System
- Anatomy
- Peripheral Nervous System
- Physiology
- Brain
- Physiological Changes
- Cardiovascular System
- Respiratory System
- Anesthesia Consideration
- The Renal System
- Anesthesia Consideration
- Gastrointestinal and Endocrine
- Musculoskeletal System
- Anesthesia Considerations for Geriatric Patients
- Pre-Operative Assessment
- Anesthetic Management & Techniques
- General Anesthesia
- Regional Anesthesia
- Peripheral Nerve Blocks
- Fluid Management
- Hypothermia
- Oxygen Therapy
- Postoperative Respiratory Complications
- Conclusion
- References
- Reuben D’Souza and George Hsu
- Introduction
- Pharmacologic Changes With Aging
- Body Composition
- Hepatic Function
- Renal Function
- Pharmacodynamics
- Protein Binding
- Mac (Minimum Alveolar Concentration)
- Anesthetics
- Benzodiazepines
- Hypnotics/Sedatives
- Propofol
- Etomidate
- Ketamine
- Opioids
- Non-Opioid Analgesia
- Muscle Relaxants (Paralytics) and Reversal Agents
- Local Anesthetics
- Polypharmacy
- Medication Adverse Events in the Elderly
- Beers Criteria
- Drug Cascades
- Frailty
- Non-Prescription Medications and Herbals
- Postoperative Delirium
- Postoperative Cognitive Dysfunction
- Conclusion
- References
- Kathleen Kwiatt and Robin Szewczak
- Introduction
- Definition and Epidemiology
- Cognitive Function and Capacity
- Cognitive Function
- Delirium
- Capacity
- Depression
- Baseline Functional Status
- Katz and Lawton Scales for Activities of Daily Living (Adls)
- Frailty
- Fall Risk
- Nutrition
- Cardiovascular Function
- Pulmonary Function
- Pharmacology
- Polypharmacy
- Beers Criteria
- Stopp/Start Criteria
- Substance Use and Abuse
- Non-Prescribed Drugs
- Smoking
- Alcohol
- Surgical and Anesthetic Planning
- Counseling and Goals of Care
- Informed Consent
- Surprise Question
- Best Case/ Worst Case
- Surrogate Decision Maker
- Discharge Planning
- Conclusion
- References
- Rachel Madison and Ian Brotman
- Introduction
- Neurologic Complications
- Postoperative Delirium
- Postoperative Nausea and Vomiting (Ponv)
- Renal Complications
- Endocrine Complications
- Hypothermia
- Hypoglycemia
- Cardiac Complications
- Myocardial Infarction
- Cardiac Arrhythmias
- Decompensated Heart Failure
- Pulmonary Complications
- Atelectasis
- Pneumonia
- Analgesic Considerations
- Conclusion
- References
- Michele Mele, Magdy Takla and Nikhil Bhana
- Background and Incidence
- Nomenclature
- Economic Burden of Pocd
- Risk Factors for Pocd
- Pathophysiology
- Neuro-Inflammation
- Impaired Neurotransmitters Systems
- Cerebral Vascular Events
- Neurocognitive Status Testing
- Risk Reduction
- Intraoperative Management
- Anesthetic Drugs
- Intraoperative Eeg Monitoring
- Inhalation Agents Versus Total Intravenous Anesthesia (Tiva)
- Dexmedetomidine
- Intraoperative Physiology
- Conclusion
- References
- William Marion, Anthony Hikes and Michael Mahrous
- Introduction
- Epidemiology
- Definition and Stages of Heart Failure
- At Risk (Stage A)
- Pre-Hf (Stage B)
- Hf (Stage C)
- Advanced Hf (Stage D)
- Signs and Symptoms
- Symptomatology
- Signs
- Etiology and Contributing Factors in the Elderly Patient
- Ischemic Heart Disease
- Systemic Hypertension
- Valvular Heart Disease
- Cardiac Amyloidosis
- Assessment of Elderly With Suspected Chf
- Treatment of Chf Caused by Systolic Dysfunction
- Management of Chf Caused by Diastolic Dysfunction
- Perioperative Management of Elderly Patient With Chf
- Preoperative
- Intraoperative
- Non-Cardiac Surgery After Cabg
- Preoperative Evaluation
- Intraoperative Considerations
- Postoperative Management
- Conclusion
- References
- Abhishek Patel, Christopher Mahrous and Dejan Vuckovic
- Introduction
- Risk Assessment and Management for Noncardiac Surgery
- The Role of Preoperative Cardiac Testing
- Intraoperative Considerations: Patient Monitoring
- General Post-Operative Considerations
- Special Considerations for Cardiac Risk in Geriatric Patients
- Perioperative Management of Anticoagulation for Valve
- Pathologies
- Perioperative Management for Patients With a History Of
- Coronary Stent
- References
Author
- Bharathi Gourkanti
- Dinesh Chaudhry
- Irwin Gratz
- Keyur Trivedi
