고령화 사회의 노인마취

Abstract

Aging is a process of the gradual reduction of functional reserve, and when it begins and how fast it proceeds are different from patient to patient. Therefore, it is important to thoroughly evaluate the current status of an elderly patient. Based on an in-depth understanding of pharmacokinetic and pharmacodynamic changes that occur due to aging, sophisticated titration of doses and infusion rates of drugs depending on the current functional status of the patient is essential for hemodynamic stability. Physicians must always keep in mind that the top priority of geriatric anesthetic management is the rapid return of functional independence. Therefore, wher-ever practical, it is prudent to use drug(s) of short duration, and metabolic processes not affected by the current disease and/or the proposed surgical procedures. Active preoperative assessment of cardiac and cerebrovascular risk factors and adequate postoperative pain relief are important to prevent postoperative cognitive dysfunction, which delays functional recovery.