Chapter

Anaesthesia for orthopaedic surgery in the elderly

Chris Dodds, Chandra M. Kumar and Frédérique Servin

in Anaesthesia for the Elderly Patient

Published on behalf of Oxford University Press

Published in print October 2007 | ISBN: 9780199234622
Published online May 2011 | e-ISBN: 9780199607082 | DOI: http://dx.doi.org/10.1093/med/9780199234622.003.0007

Series: Oxford Anaesthesia Library

Anaesthesia for orthopaedic surgery in the elderly

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Elderly patients may have significant organ dysfunction.

Cardiorespiratory, renal, neurological dysfunctions and arthritis are common.

Major joint surgery is increasingly performed.

Pre-operative assessment is essential to optimize the disease state.

Elderly patients may be malnourished.

There is no single clear technique of anaesthesia.

The use of cement during surgery is known to be associated with intra-operative morbidities.

Tourniquet use is common during distal bone or joint surgery.

Sedation is commonly used when regional technique is in use.

Deep vein thrombosis (DVT) prophylaxis is necessary in patients undergoing major joint surgery.

Antibiotics are routinely used but must be administered before tourniquet is used.

Blood loss may be excessive especially during revision surgery and measures should be taken to minimize blood loss.

Regional technique with opioid provides good analgesia.

Patient controlled analgesia (PCA) with opioid is a good method but patient may not use it properly because of arthritis or impaired cognitive function.

Prolonged use of urinary catheter should be avoided.

Delirium is common in elderly and occurs to some degree in the vast majority of patients and anaesthesia may compound this problem.

Early mobilization is helpful.

Chapter.  4568 words. 

Subjects: Anaesthetics

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