Obere Altersgrenze bei ambulanter Anästhesie: Möglichkeiten und Risiken

Abstract

Ambulatory surgery in elderly patients continues to increase - avoiding hospitalization and thus postoperative cognitive dysfunction in older patients being its major objectives. An upper age limit in outpatient anesthesia does not exist to date. However, functional rather than chronological age is crucial in patient selection. In consensus discussion, baseline functional status should be evaluated regularly - defined as everyday behaviors necessary to maintain daily life and encompassing areas of physical, cognitive, and social functioning. Moreover, frailty in elderly patients can be quantified objectively and is associated with increased perioperative morbidity in ambulatory general surgery. The decision for or against outpatient anesthesia therefore remains a case-by-case decision which should be discussed within a team.

Ambulatory anesthesia: restructuring for success

“…Rajan et al provide a comprehensive overview of those factors including recommendations regarding postponement of a procedure, pain management or postinterventional hospitalization [15 && ]. The proportion of elderly people undergoing ambulatory anesthesia has steadily increased within the last years in parallel with the aging of the global population [16,17]. Patients of higher age benefit from recovering in a familiar environment, faster mobilization and lower rates of nosocomial infections further promoting the shift towards ambulatory surgery for this population [16,18].…”