Geriatric anaesthesia: Challenges and recent updates – A review

Geriatric anaesthesia is a rapidly growing subspecialty due to the rising number of elderly individuals undergoing surgical procedures. Older adults present a unique set of challenges, including physiological changes, polypharmacy, and comorbidities, all of which can significantly influence anaesthetic management. Age-related alterations in pharmacokinetics and pharmacodynamics make dosing and drug selection more complex. Additionally, the elderly are at a higher risk of perioperative complications such as postoperative cognitive dysfunction (POCD) and delirium. Recent advancements in geriatric anaesthesia have focused on better preoperative assessments, personalized anaesthetic strategies, and enhanced recovery protocols to reduce postoperative morbidity. This review aims to explore the challenges faced in anaesthetizing the elderly and highlights recent updates in the field, including the development of frailty assessment tools, use of regional anaesthesia, and the role of multidisciplinary teams in perioperative care. By optimizing perioperative care, including pain management, anaesthetic depth monitoring, and the prevention of delirium, outcomes for elderly patients can be significantly improved. This article provides a comprehensive review of the current state of geriatric anaesthesia, with a focus on both the challenges faced and innovations that have emerged to improve patient care.