Should general anaesthesia be avoided in the elderly?

Should general anaesthesia be avoided in the elderly?
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DOI:
10.1111/anae.12493
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发表时间:
2014-01
期刊:
影响因子:
10.7
通讯作者:
Sieber FE
Sieber FE
中科院分区:
医学1区
文献类型:
--
作者:
Strøm C;Rasmussen LS;Sieber FE

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手术和麻醉对老年人的不良影响相对大于对年轻大脑的不良影响,表现为术后谵妄和认知功能障碍的发生率较高。术后谵妄和认知功能障碍延迟康复,并与老年手术患者发病率和死亡率的增加有关。我们回顾了老年人术后谵妄和认知功能障碍的病因,特别关注麻醉和镇静,讨论了诊断和监测术后认知功能下降的方法,并描述了预防这种下降的治疗策略。
Surgery and anaesthesia exert comparatively greater adverse effects on the elderly than on the younger brain, manifest by the higher prevalence of postoperative delirium and cognitive dysfunction. Postoperative delirium and cognitive dysfunction delay rehabilitation, and are associated with increases in morbidity and mortality among elderly surgical patients. We review the aetiology of postoperative delirium and cognitive dysfunction in the elderly with a particular focus on anaesthesia and sedation, discuss methods of diagnosing and monitoring postoperative cognitive decline, and describe the treatment strategies by which such decline may be prevented.
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