Texas Society of Anesthesiologists

Seniors and Anesthesia

More than 12 percent of the U.S. population is older than 65 – and more than half of those will undergo at least one surgical procedure as senior citizens. In the coming years, the number of retirees, as well as the number of them having surgery, is expected to grow substantially.

Senior citizens face increased risks for complications during and after surgery. These may include postoperative delirium, a condition that causes some patients to become confused and disoriented for up to a week after surgery, and postoperative cognitive dysfunction (POCD), which is defined as having long-term problems with loss of memory, learning and the ability to concentrate.

Your anesthesiologist can discuss these risks with you and answer any questions you may have about having surgery as a senior citizen. In addition, TSA has many resources in this section to help prepare you for your procedure.

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Important Tips for Seniors and Their Caregivers Prior to Surgery 

Get to Know Your Physicians

Before making a decision about surgery, find out whether it’s really necessary and what benefits it will provide. You also should talk to the anesthesiologist prior to surgery. Consider scheduling a consultation with a geriatric anesthesiology specialist, particularly if you are taking multiple medications. A geriatric anesthesiologist has specific experience caring for the elderly both preoperatively and postoperatively.

Please note that if you are depressed, it can be helpful to see a psychiatrist and seek treatment prior to surgery. This is extremely important because depression has been tied to higher mortality rates in surgical patients. The psychiatrist, in consultation with other members of the surgical team, may also recommend minimizing the use of sedatives, especially long-acting drugs such as benzodiazepines.

Don’t Be Afraid to Ask Questions

Having a surgical procedure can bring up a lot of questions. You should bring a list of all your questions to your preoperative appointments, and don’t be afraid to keep asking until you feel you understand the answer. Some questions you may want to ask are:

List Your Medications and Other Regularly Used Substances

You must provide your physician with a comprehensive list of all medications you take, including prescriptions, over-the-counter and herbal supplements, as some of these can affect your anesthesia and surgery. Sleeping pills, anxiety medications and alcohol withdrawal have been shown to increase the risk of postoperative complications in the elderly. Download and fill out the ASA’s Checklist of Emergency Contact Information and Current Medications. Be sure to have it with you at all times.

Learn Your Anesthesia Plan

Ask your anesthesiologist about the type of anesthesia that will be used during your procedure – general, regional or local, as well as potential effects of the medication. He or she is your partner in the operating room, so feel free to ask as many questions as you need to in order to feel comfortable.

Get Your Support System in Place

Surgery can be an overwhelming experience, and family and friends can be an invaluable resource. They are especially important during the recovery period by doing such things as:

Stay Vigilant for Complications

After a successful surgical outcome, it is easy to fall back into a daily routine and forget to watch out for post-surgical complications, which may include cognitive problems or issues with mental function. Some suggestions to minimize this are:

Surgical Checklist for Seniors 

Medication Checklist 

Alzheimer's Disease and Anesthesia

Approximately 12 percent of the U.S. population is older than 65 years. Half of these individuals will have some form of surgery in their lifetime. One type of anesthesia commonly used during surgery is inhaled general anesthesia and, until recently, it was assumed to be nontoxic and readily eliminated at the end of surgery.

Recent cell and animal research suggests inhaled anesthesia may cause changes in the brain similar to those seen in individuals with Alzheimer’s disease. While these findings are concerning, it is important to recognize that the animals in these studies were given much higher and frequent doses of inhaled anesthesia than human patients would receive. For example, the animals received anesthesia as much as 25 times over a three-month period.

There is currently no human data to indicate that patients who receive inhaled anesthesia will be at an increased risk for Alzheimer’s disease. If you have any concerns, discuss your anesthetic options and risk factors with your anesthesiologist prior to surgery.

Copyright © 2014 American Society of Anesthesiologists.
All rights reserved. Reprinted with permission.