ANAESTHESIA FOR OPHTHALMIC SURGERY IN GERIATRIC PATIENT

Abstract

An absolute definition of geriatric patients IS not possible smce arbitrary limits constantly change. Geriatric patients were previously defined as tl10se individuals over 65 years of age, although it is recognized that there is not necessarily a correlation between chronologie and biologic age.

One half of patients who reach 65 years of age will require surgery such as cataract extraction.

It was reported that elderly patients may be at great risk for preoperative and postoperative morbidity and mortality as a result of anaesthesia and surgery because of two separate factors: first, an increased prevalence of age related concomitant diseases, and second a decline in basic organ fimction together with decreased margin of reserve and altered response to drugs that accompany aging. Preoperative evaluation of geriatric patients must consider the likely presence of co-existing diseases of major organ systems. Hazards of the co- existing diseases can present witl1 increase in postoperative morbidity and mortality in geriatric patients.

Co- existing diseases that frequently accompany aging and influence management in the perioperative period include systemic hypertension, coronary artery disease, heart failure, chronic obstructive pulmonary disease, diabetes mellitus, rheumatoid arthritis and osteoarthrosis.

Patients undergoing ophthalmic surgery have available two maJor anaesthetic options: general and local (regional or nonkinetic) anaesthesia.