Anesthetic considerations in geriatric patients
- Respiratory and Cardiovascular Changes in Geriatric Patients:
Geriatric patients experience decreased lung capacity due to increased functional residual capacity (FRC) and small airway closure. This is coupled with muscle atrophy and reduced reflexes, making intubation necessary. Cardiovascular changes include reduced cardiac reserve due to decreased maximum heart rate and valvular lesions, which reduce cardiac output and increase myocardial workload. - Decreased Renal and Digestive Function:
Renal function diminishes with age, reducing the ability to concentrate urine and making fluid balance critical.Lower esophageal sphincter tone decreases, and gastric pH becomes lower, making older patients more prone to reflux and esophagitis. - Altered Drug Metabolism and Clearance:
Geriatric patients show a reduction in drug clearance and protein binding, leading to potentially higher effective drug concentrations. Special care is needed to avoid drug overdose or prolonged drug effects. - Pre-Anesthetic and Anesthetic Considerations:
Pre-anesthetic preparation should include securing venous access early, minimizing stress, and using analgesia. Induction with propofol and intubation, followed by inhalant or total intravenous anesthesia (TIVA), is recommended. - Post-Anesthetic Care:
Recovery requires close monitoring until airway reflexes return. Supplemental oxygen, analgesia, fluid therapy, and temperature management are essential for a safe recovery.
Dr Robert Trujanovic studied at the Faculty of Veterinary Medicine in Belgrade, where he graduated in veterinary medicine in 2015. He moved to Vienna in 2015 to start his position as assistant doctor in anesthesiology at the University of Veterinary Medicine Vienna, and later, he completed his internship there from 2017-2018.
During this time, his interest in veterinary anesthesia deepened further and he started a residency at the Vetmeduni Vienna in 2018, which was completed in 2021.
In addition, he is a passionate regional anesthetist, passing on his knowledge through the latest learning methods. He led a team of experts in veterinary medicine and invested a great deal of passion into creating the first mobile app - the Vet RA App - focused on the most commonly used nerve blocks in small animals.
During this time, his interest in veterinary anesthesia deepened further and he started a residency at the Vetmeduni Vienna in 2018, which was completed in 2021.
In addition, he is a passionate regional anesthetist, passing on his knowledge through the latest learning methods. He led a team of experts in veterinary medicine and invested a great deal of passion into creating the first mobile app - the Vet RA App - focused on the most commonly used nerve blocks in small animals.