Index. Note: Page numbers of article titles are in boldface type.

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1 Note: Page numbers of article titles are in boldface type. A Adverse drug events, polypharmacy and perioperative considerations in elderly patients, Age, and risk of postoperative urinary retention, Aging, cardiovascular, and diastolic dysfunction, normal, effect on delayed arousal, pharmacologic effects of, beta-blockers and, Airway management, in DBS lead placement for Parkinson s disease, 402 Alzheimer s disease, cholinesterase inhibitors and, perioperative considerations for patients on, 387 Ambulatory surgery, discharge criteria for, and risk of postoperative urinary retention, Analgesia, and postoperative pain, role in development of urinary retention, 472 Anesthesia, in geriatric patients, acute mesenteric ischemia, aortic valve stenosis, atrial fibrillation in, beta-blockers, delayed arousal in, diastolic dysfunction and cardiovascular aging, fat embolism, in patients with skin breakdown, informed consent and ethical management, Parkinson s disease and deep brain stimulator placement, polypharmacy and perioperative medications, postoperative cognitive dysfunction, postoperative delirium, postoperative urinary retention, Anesthetic technique, role in development of postoperative urinary retention, Anticholinergic activity, of medications in older patients, Anticoagulation, for atrial fibrillation in the elderly, Antiparkinson medication, perioperative considerations for elderly patients on, 386 Aortic valve stenosis, in elderly patients, anesthesia for noncardiac surgery in patients with, classification criteria, 522 modulating therapies and strategies in, natural progression and course of, pathophysiology, physical examination and clinical presentation, 523 replacement, Arousal, from anesthesia, delayed, see Delayed arousal. Anesthesiology Clin 27 (2009) doi: /s (09)00086-x anesthesiology.theclinics.com /09/$ see front matter ª 2009 Elsevier Inc. All rights reserved.

2 606 Arrhthymias, atrial fibrillation in the elderly, Ascending arousal system, nonthalamic branch, thalamic branch, Atrial fibrillation, in cardiac surgery, chronic use of beta-blockers in, 583 in the elderly, case studies, etiology and pathophysiology, 419 incidence and prevalence, management, anticoagulation, catheter ablation, 424 echocardiography, 423 electrical cardioversion, 420 MAZE procedure, 422 pacing, pharmacologic interventions, 420 rate control, rhythm control, 422 scenarios arising during perioperative period, Autonomy, patient, promoting during informed consent process, B Beers criteria, for inappropriate prescribing in the elderly, 381 Beta-blockers, perioperative use in elderly patients, common comorbidities benefiting from chronic use of, atrial fibrillation in cardiac surgery, 583 congestive heart failure, 583 coronary artery disease, 584 hypertension, pharmacologic effects of aging, prophylactic use of, contraindications, duration of, 590 overview of studies on, target population for, 585 timing, dosage, and choice of, treatment effect, 589 recommendations, 592 Bladder catheterization, duration of, and risk of postoperative urinary retention, 476 Blood pressure, control of, in acute mesenteric ischemia, 600 Brain imaging, in assessment of postoperative cognitive dysfunction in the elderly, 492 C Cardiac arrhythmias, atrial fibrillation in the elderly, Cardiac surgery, in patient with diastolic dysfunction, Cardiovascular aging, diastolic dysfunction and, Cardiovascular dysfunction. See also Heart disease. in patients with fat embolism, 540 Cardiovascular medications, perioperative considerations for elderly patients on,

3 607 Cardioversion, electrical, for atrial fibrillation in the elderly, 420 Cascades, drug, in older patients, 382 Catheter ablation, for atrial fibrillation in the elderly, 424 Catheterization, bladder, duration of, and risk of postoperative urinary retention, 476 Central nervous system dysfunction, in patients with fat embolism, 540 Cholinesterase inhibitors, perioperative considerations for elderly patients on, 387 Classification, of aortic stenosis in the elderly, 522 Clock drawing test, in assessment of postoperative cognitive dysfunction in the elderly, Cognitive dysfunction, postoperative, in the elderly, assessment, clock drawing test, list-learning test, 492 Mini Mental State Examination, 491 other tests, 492 paragraph or story memory test, 492 brain imaging, 492 consequences of, delirium, , 486 general anesthesia, surgery, and development of, anesthetic agents, surgical factors, 490 incidence and risk factors, normocapnia vs. hypercapnia, 489 normotensive vs. hypotensive anesthesia, physiology of aging, prevention, Competence, of geriatric patient, assessment of, 573 Complications, postoperative, in the elderly, cognitive dysfunction, delayed arousal, delirium, urinary retention, with acute mesenteric ischemia, Computerized tomography (CT), for delayed arousal in elderly, 441 Congestive heart failure, chronic use of beta-blockers in, 583 Consciousness, arousal pathways and effect of normal aging on delayed arousal, aging, cortex as site of end-effect, nonthalamic branch of ascending arousal system, thalamic branch of ascending arousal system, ventrolateral preoptic nucleus, delayed arousal in states of, Consent. See Informed consent. Consultation, preoperative, and risk of postoperative urinary retention, Coronary artery disease, chronic use of beta-blockers in, 584 Cortex, end-effect, in delayed arousal, D DBS. See Deep brain stimulation. Decubitus ulcers, anatomy of, 599

4 608 Deep brain stimulation (DBS), for Parkinson s disease, anesthesia for DBS lead placement, stage 1, stage 2, 404 for surgery in patients with implanted DBS, treatment with, Delayed arousal, in elderly patients, algorithm for approaching patient with, computerized tomography, 441 electrolytes, 444 magnetic resonance imaging, 441 metabolic abnormalities, seizures, 442 workup, arousal pathways and effect of normal aging, aging, cortex as site of end-effect, nonthalamic branch of ascending arousal system, thalamic branch of ascending arousal system, ventrolateral preoptic nucleus, in states of consciousness, pharmacology, Delirium, postoperative, in elderly patients, , case presentation, diagnosis, epidemiology, financial implications, 453 mechanism, role of anesthesia, treatment issues, Dexmedetomidine, sedation for DBS lead placement for Parkinson s disease, Diabetes, anesthetic care for patients with skin breakdown, Diastolic dysfunction, cardiovascular aging, anesthesia and, anesthetic management of for general surgery patient, cardiac surgery patient with, physiologic changes of aging and, Discharge criteria, for ambulatory surgery patients, and risk of postoperative urinary retention, Do-not-resuscitate (DNR) orders, Doppler imaging, diastolic dysfunction, Drug cascades, in older patients, 382 E Echocardiography, diastolic dysfunction, for atrial fibrillation in the elderly, 423 Elderly. See Geriatric patients. Electrical cardioversion, for atrial fibrillation in the elderly, 420 Electrocautery, in Parkinson s disease patients with implanted DBS, 408 Electroencephalography, for seizures and delayed arousal in elderly and, processed, in DBS lead placement for Parkinson s disease,

5 609 Electrolytes, delayed arousal in elderly, 444 Embolism, fat, in the elderly, case presentation, clinical presentation, definition, 534 diagnosis, epidemiology, etiology, history, 534 management, pathophysiology, prognosis, 544 venous air, during DBS lead placement for Parkinson s disease, 403 Epidemiology, fat embolism, postoperative delirium in elderly patients, Epidural analgesia, role in development of postoperative urinary retention, Ethical issues, informed consent by older patients, Eyes., disorders in patients with fat embolism, 540 F Fat embolism. See Embolism, fat. Financial impact, postoperative delirium in elderly patients, 453 Fluids, intravenous, resuscitation in acute mesenteric ischemia, dynamic goal-directed, role in development of postoperative urinary retention, G Gender, and risk of postoperative urinary retention, General anesthesia, and postoperative cognitive dysfunction in the elderly, for DBS lead placement for Parkinson s disease, 400 for patient with chronic wound, 602 Geriatric patients, anesthetic considerations in, acute mesenteric ischemia, anesthesia, clinical presentation, control of blood pressure, 600 dynamic goal-directed fluid resuscitation, dynamic measurement of systolic and pulse pressure variation, 559 fluid resuscitation, global measures of tissue perfusion, pathophysiology, postoperative complications, 601 preoperative considerations, 557 traditional and static variables, 558 treatment options, aortic valve stenosis, anesthesia for noncardiac surgery in patients with, classification criteria, 522 modulating therapies and strategies in, natural progression and course of,

6 610 Geriatric (continued) pathophysiology, physical examination and clinical presentation, 523 replacement, atrial fibrillation in, case studies, etiology and pathophysiology, 419 incidence and prevalence, management, beta-blockers, perioperative use of, common comorbidities benefiting from chronic use of, pharmacologic effects of aging, prophylactic use of, recommendations, 592 cognitive dysfunction, postoperative, assessment, consequences of, delirium, 486 incidence and risk factors, physiology of aging, prevention, delayed arousal in, algorithm for approaching patient with, arousal pathways and effect of normal aging, pharmacology, delirium, postoperative, case presentation, diagnosis, epidemiology, financial implications, 453 mechanism, role of anesthesia, treatment issues, diastolic dysfunction, anesthetic management of for general surgery patient, cardiac surgery patient with, physiologic changes of aging and, fat embolism, case presentation, clinical presentation, definition, 534 diagnosis, epidemiology, etiology, history, 534 management, pathophysiology, prognosis, 544 in patients with skin breakdown, anatomy of decubitus ulcers, anesthetic care of patients with chronic wounds,

7 611 selecting an anesthetic regimen, 602 informed consent and ethical management, assessing competence in, 573 elements of, 571 informed refusal and do-not-resuscitate orders, managing the incompetent patient, promoting patient autonomy during, special problems facing elderly, Parkinson s disease, for deep brain stimulator (DBS) lead placement, for non-parkinson s disease surgery, for surgery in patients with implanted DBS, treatment of, polypharmacy and perioperative medications, adverse events related to medications, anticholinergic activity, Beers criteria for inappropriate prescribing, 381 drug cascades, 382 medication histories, 383 medications in older patients, 379 over-the-counter and herbal remedies, 383 perioperative considerations, pharmacologic considerations, urinary retention, postoperative, demographic risk factors for, diagnosis, 467 management of, perioperative factors influencing development of, physiology of micturition, H Haloperidol, perioperative considerations for elderly patients on, 386 Heart disease, diastolic dysfunction, anesthetic management of for general surgery patient, cardiac surgery patient with, physiologic changes of aging and, Heart disease, in the elderly, aortic valve stenosis, atrial fibrillation, Hemodynamic monitoring, in DBS lead placement for Parkinson s disease, 402 Hemorrhage, intracerebral, during DBS lead placement for Parkinson s disease, 404 Herbal medications, in older patients, 383 Histories, medication, in older patients, 383 Hypercapnia, vs. normocapnia, and risk of postoperative cognitive dysfunction in the elderly, 489 Hypertension, chronic use of beta-blockers in, Hypotensive anesthesia, vs. normotensive, and risk of postoperative cognitive dysfunction in the elderly, I Imaging, brain, in assessment of postoperative cognitive dysfunction in the elderly, 492 in diagnosis of fat embolism,

8 612 Imaging (continued) tissue Doppler, in diastolic dysfunction, Incompetent patients, elderly, management of, surrogate consent for research, 576 Informed consent, by older patients, assessing competence in, 573 elements of, 571 informed refusal and do-not-resuscitate orders, managing the incompetent patient, promoting patient autonomy during, special problems facing elderly, Informed refusal, by older patients, Intracerebral hemorrhage, during DBS lead placement for Parkinson s disease, 404 Intravenous fluids, resuscitation in acute mesenteric ischemia, dynamic goal-directed, role in development of postoperative urinary retention, L Lesioning, for treatment of Parkinson s disease, 392 Local anesthetics, limits of, for patient with chronic wound, with sedation, for patient with chronic wound, 602 M Magnetic resonance imaging (MRI), for delayed arousal in elderly, in Parkinson s disease patients with implanted DBS, 405, 408 MAZE procedure, for atrial fibrillation in the elderly, 422 Medications, in older patients, 379 adverse events related to, chronic, perioperative considerations with, drug cascades, 382 histories, 383 over-the-counter and herbal, 383 See also Polypharmacy. Memory tests, in assessment of postoperative cognitive dysfunction in the elderly, 492 Meperidine, perioperative considerations for elderly patients on, Metabolic abnormalities, delayed arousal in elderly, Micturition, physiology of, Mini Mental State Examination, in assessment of postoperative cognitive dysfunction in the elderly, 491 Monoamine oxidase inhibitors, perioperative considerations for elderly patients on, N Neuropathy, in patient with chronic wound, 601 Nonsteroidal anti-inflammatory drugs (NSAIDs), role in development of postoperative urinary retention, 474 Nonthalamic branch, of ascending arousal system,

9 613 Normocapnia, vs. hypocapnia, and risk of postoperative cognitive dysfunction in the elderly, 489 Normotensive anesthesia, vs. hypotensive, and risk of postoperative cognitive dysfunction in the elderly, O Older patients. See Geriatric patients. Opioids, role in development of postoperative urinary retention, Over-the-counter medications, in older patients, 383 P Pacing, for atrial fibrillation in the elderly, Pain, postoperative, role in development of urinary retention, 472 Parkinson s disease, anesthetic considerations for patients with, for deep brain stimulator (DBS) lead placement, stage 1, stage 2, 404 for non-parkinson s disease surgery, for surgery in patients with implanted DBS, treatment of, medical, 392 surgical, Pathophysiology, acute mesenteric ischemia, fat embolism, of aortic stenosis in the elderly, Perfusion, tissue, global measure of, in acute mesenteric ischemia, Pharmacodynamics, in elderly patients, Pharmacokinetics, in elderly patients, Pharmacology, considerations in elderly patients, narrow therapeutic range, 384 pharmacokinetics and pharmacodynamics, physiologic alterations, 384 of delayed arousal in the elderly, 436 Physiology, of aging, Platelets, in patients with fat embolism, 540 Polypharmacy, and perioperative medications in the elderly, adverse events related to medications, anticholinergic activity, Beers criteria for inappropriate prescribing, 381 drug cascades, 382 medication histories, 383 medications in older patients, 379 over-the-counter and herbal remedies, 383 perioperative considerations, pharmacologic considerations, Postoperative complications, in the elderly, cognitive dysfunction, delayed arousal, delirium, urinary retention, with acute mesenteric ischemia,

10 614 Preoperative consultation, and risk of postoperative urinary retention, Prescribing, drug cascades in older patients, 382 inappropriate, in the elderly, Beers criteria for, 381 Prophylactic use, of beta-blockers, perioperative, in elderly patients, contraindications, duration of, 590 overview of studies on, target population for, 585 timing, dosage, and choice of, treatment effect, 589 Propofol, sedation for DBS lead placement for Parkinson s disease, 399 Psychotropic medications, perioperative considerations for elderly patients on, 385 R Regional anesthesia, for DBS lead placement for Parkinson s disease, 398 Research, surrogate consent for incompetent patients, 576 Respiratory dysfunction, in patients with fat embolism, Retention, urinary. See Urinary retention. S Sedation, local with, for patient with chronic wound, 602 Seizures, delayed arousal in elderly and, Serotonergic reuptake inhibitors, perioperative considerations for elderly patients on, 386 Skin breakdown, anesthetic care for patients with, anatomy of decubitus ulcers, in patients with chronic wounds, selecting an anesthetic regimen, 602 Skin disorders, in patients with fat embolism, 540 Spinal anesthesia, for patient with chronic wound, 602 Splanchnic circulation, acute mesenteric ischemia in the elderly, anesthetic management of, Stereotactic head-frame placement, for DBS for Parkinson s disease, Surgical procedure, role in development of postoperative urinary retention, Surgical stress, and postoperative cognitive dysfunction in the elderly, 490 Surrogate consent, for research, for incompetent patients, 576 T Thalamic branch, of ascending arousal system, Therapeutic index, low, in elderly patients, 384 Therapeutic range, narrow, in elderly patients, 384 Tissue Doppler imaging, diastolic dysfunction, U Ulcers, anesthetic care for patients with skin breakdown, anatomy of decubitus ulcers, in patients with chronic wounds, selecting an anesthetic regimen, 602

11 615 Urinary retention, postoperative, demographic risk factors for, abnormal voiding history, 475 age and gender, diagnosis, 467 management, discharge criteria for ambulatory surgical patients, duration of bladder catheterization, 476 intraoperative considerations, pharmacologic, 477 preoperative consultation, 475 perioperative factors influencing development of, anesthetic techniques, epidural analgesia, intravenous fluids, NSAIDs, 474 opioids, postoperative pain and analgesia, 472 surgical procedure, physiology of micturition, V Valve replacement, for aortic stenosis in the elderly, Venous air embolism, during DBS lead placement for Parkinson s disease, 403 Ventrolateral preoptic nucleus, in delayed arousal, Voiding dysfunction, postoperative urinary retention, Voiding history, abnormal, and risk of postoperative urinary retention, 475 W Wounds, chronic, anesthetic care for patients with skin breakdown, anatomy of decubitus ulcers, in patients with, selecting an anesthetic regimen, 602