Anesthetic considerations in geriatric patients

Dr. Robert TRUJANOVIC
Dipl. ECVAA
Duração : 21 min
Medicina Geriátrica Anestesiologia e analgesia
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  • 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.
Robert studierte an der Veterinärmedizinischen Fakultät in Belgrad, wo er 2015 sein Studium der Veterinärmedizin abschloss. Direkt darauf zog er nach Wien, um eine Stelle als Assistenzarzt im Department der Anästhesiologie an der Veterinärmedizinischen Universität Wien anzutreten.

In dieser Zeit vertiefte sich sein Interesse an der Veterinäranästhesie weiter und er begann 2018 eine Residency, die er 2021 abgeschlossen hat.

Inspiriert von den Entwicklungen in der veterinärmedizinischen Regionalanästhesie, leitete er ein Team von Experten in der Veterinärmedizin und investierte viel Leidenschaft in die Entwicklung der ersten mobilen App, die sich auf die am häufigsten verwendeten Nervenblockaden bei Kleintieren konzentriert.