Anesthesia for Orthopedic Surgery in the Geriatric Patient

Evaluation of the geriatric patient for orthopedic operations is similar to patient evaluation for any other procedure. Concomitant diseases must be diagnosed and treated to bring the patient to an optimal physical status. The evaluation can only be thorough when the anesthesiologist has a good understanding of indications for the procedure, the pathophysiology involved and knowledge about the operative procedure.

Communication at all levels of the medical care system must continue to be developed to maintain a high level of patient care in face of increasing pressures from various cost containment programs. Premedication must be individualized and big doses require surveillance.

Orthopedic operations performed in geriatric patients frequently lend themselves to regional anesthesia but anesthesiologists' skill may be a limitation. It continues to be controversial whether regional anesthesia reduces morbidity and mortality over general anesthesia. General anesthesia is indicated if this is the technique with which the anesthesiologist is most familiar and if it is what the informed patient requests.