Clinical correlates and outcomes of anaesthesia for the elderly surgical patient in a tertiary hospital

Abstract

Background: The anaesthestic management of the elderly surgical patients deserves attention because of the increased risk of intercurrent medical diseases.  This retrospective study evaluated the reasons for surgical care and the pattern of anaesthesia provided.

Methodology: This retrospective study of all elderly patients billed for surgery irrespective of the surgical specialties over a 13year period (1997-2010).  Indication for surgery, anaesthetic technique, level of anaesthetist / surgeon and procedures performed were studied.

Results: A total 1168 elderly patients were operated during the study period, of which 678(58%) were male while 490 (42%) were female. Ophthalmology and Urology recorded the highest surgeries respectively. The commonest procedures included cataract extraction 399 (9.25%) with a male preponderance and prostatectomy 166 (6.17%). The anaesthetic techniques commonly used include Local Anaesthesia 733 (62.8%) and General Anaesthesia 302 (25.8%). The cadre of the attending anaesthetists included consultant Anaesthetists 130(11.1%) while Senior Registrars provided care for 280(29.1%). The level of attending surgeons includes consultants 757 (64.8%) while Senior Registrars account for 399 (34.2%).

Conclusion: Age alone is no longer a barrier to surgery and anaesthesia.  Ageing changes the body’s capacity to cope with the stress of illness and surgery. To reduce morbidity and mortality less invasive technique like Local Anaesthesia (LA) should be used while consultant surgeons and anaesthetists should provide the perioperative care.