Perioperative management of geriatric patients. Project of clinical recommendations

The need for surgical treatment in elderly patients arises four times more often than the population average. Due to the tendency to increase life expectancy, the number of elderly patients who underwent surgery increases, which requires an increase in the geriatric care, including surgical and anesthetic care. It is well known that in comparison with young patients, older subjects have a higher risk of developing adverse postoperative outcomes as a result of age-related decline in physiological functions, the presence of several comorbidities, polypharmacy, cognitive dysfunction and specific geriatric syndromes such as frailty. The presented recommendations generalize modern principles of perioperative management in patients of older age groups. Particular attention is paid to the peculiarities of preoperative examination, including the evaluation of geriatric syndromes, the choice of anesthesia method and the correct calculation of doses of drugs for anesthesia. Great importance at the present time made the role of cognitive status of older patients and post-operative cognitive dysfunction, which substantially affects the outcome of the disease. These recommendations include measures to assess cognitive status and prevent complications associated with cognitive impairment. Individualization of approach to management of geriatric patients is the basis of effective prevention of perioperative complications.