{"title":"老年创伤患者的围手术期处理。","authors":"Maeve Muldowney, Pudkrong Aichholz, Melina Cox, Itay Bentov","doi":"10.1007/s40140-024-00673-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>An increasing number of trauma patients are elderly. These patients present unique challenges due to their distinct physiological changes and injury patterns. This article aims to summarize recent literature on perioperative management of geriatric trauma patients for anesthesia providers.</p><p><strong>Recent findings: </strong>Ageing is a multisystem process which may impair the ability of the older person to physiologically respond to trauma. The addition of frailty may further increase their vulnerability to complications.With regards to operative planning, regional anesthesia has not been shown to reduce the risk of delirium compared to general anesthesia. This has been mostly shown with regards to hip fractures, an injury with a high incidence amongst the elderly. There was no reduction in mortality with accelerated hip fracture repair within 6 h of presentation.</p><p><strong>Summary: </strong>Geriatric patients sustain different injuries and mount more limited physiological responses to trauma than their younger counterparts. Pre-existing frailty amongst the elderly may also contribute to complications in the perioperative period.</p>","PeriodicalId":36608,"journal":{"name":"Current Anesthesiology Reports","volume":"15 ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176405/pdf/","citationCount":"0","resultStr":"{\"title\":\"Perioperative Management of the Geriatric Trauma Patient.\",\"authors\":\"Maeve Muldowney, Pudkrong Aichholz, Melina Cox, Itay Bentov\",\"doi\":\"10.1007/s40140-024-00673-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>An increasing number of trauma patients are elderly. These patients present unique challenges due to their distinct physiological changes and injury patterns. This article aims to summarize recent literature on perioperative management of geriatric trauma patients for anesthesia providers.</p><p><strong>Recent findings: </strong>Ageing is a multisystem process which may impair the ability of the older person to physiologically respond to trauma. The addition of frailty may further increase their vulnerability to complications.With regards to operative planning, regional anesthesia has not been shown to reduce the risk of delirium compared to general anesthesia. This has been mostly shown with regards to hip fractures, an injury with a high incidence amongst the elderly. There was no reduction in mortality with accelerated hip fracture repair within 6 h of presentation.</p><p><strong>Summary: </strong>Geriatric patients sustain different injuries and mount more limited physiological responses to trauma than their younger counterparts. Pre-existing frailty amongst the elderly may also contribute to complications in the perioperative period.</p>\",\"PeriodicalId\":36608,\"journal\":{\"name\":\"Current Anesthesiology Reports\",\"volume\":\"15 \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176405/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Anesthesiology Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s40140-024-00673-6\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/11 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Anesthesiology Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s40140-024-00673-6","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Perioperative Management of the Geriatric Trauma Patient.
Purpose of review: An increasing number of trauma patients are elderly. These patients present unique challenges due to their distinct physiological changes and injury patterns. This article aims to summarize recent literature on perioperative management of geriatric trauma patients for anesthesia providers.
Recent findings: Ageing is a multisystem process which may impair the ability of the older person to physiologically respond to trauma. The addition of frailty may further increase their vulnerability to complications.With regards to operative planning, regional anesthesia has not been shown to reduce the risk of delirium compared to general anesthesia. This has been mostly shown with regards to hip fractures, an injury with a high incidence amongst the elderly. There was no reduction in mortality with accelerated hip fracture repair within 6 h of presentation.
Summary: Geriatric patients sustain different injuries and mount more limited physiological responses to trauma than their younger counterparts. Pre-existing frailty amongst the elderly may also contribute to complications in the perioperative period.
期刊介绍：
This journal aims to offer expert review articles on the most significant recent developments in the field of anesthesiology. By providing clear, insightful, balanced contributions, the journal intends to serve those involved in the delivery of anesthesia for surgical and medical procedures, treatment of acute and chronic pain conditions, perioperative management for operative and intensive care unit patients, and associated basic science and clinical research efforts in their areas. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas across the field. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An Editorial Board of more than 20 internationally diverse members reviews the annual table of contents, ensures that topics include emerging research, and suggests topics of special importance to their country/region. Topics covered may include ambulatory anesthesia; anesthesia and inflammation; anesthetic mechanisms; anesthetic pharmacology; cardiovascular anesthesia; critical care anesthesia; local anesthetic pharmacology; monitoring technology; neuroanesthesia; neuromuscular blockade; obstetrical anesthesia; pain mechanisms; pain therapy; patient safety; pediatric anesthesia; quality assessment; regional anesthesia; and transplantation anesthesia.
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