Index Note: Page numbers of article titles are in boldface type. A Acetaminophen, for geriatric surgical patients, 569 570 Acute kidney injury, critical care issues in geriatric patients with, 555 556 Aging, age-related differences relevant to pain, 578 581 effects on major organ systems, 447 456 cardiovascular system, 449 451 endocrine system, 454 455 gastrointestinal system, 452 453 nervous system, 448 449 renal and volume regulation system, 453 454 respiratory system, 451 452 pharmacokinetic changes with, 459 460 American College of Surgeons (ACS), best practices guidelines for preoperative assessment of geriatric patients, 483 American Geriatrics Society (AGS), best practices guidelines for preoperative assessment of geriatric patients, 483 role in history of geriatric anesthesia, 432 433 American Society of Anesthesiologists (ASA), Committee on Geriatric Anesthesia, history of, 428 429 involvement in history of geriatric anesthesia, 434 perioperative surgical home concept, 439 445 Anesthesia, geriatric. See Geriatric anesthesia. Anesthesiologists, role in perioperative surgical home concept, 439 445 Antipsychotics, and postoperative delirium in geriatric patients, 511 512 Aortic valve replacement, transcatheter, anesthetic considerations in geriatric patients, 496 499 Arrhythmias, critical care issues in geriatric patients with, 553 554 Artificial nutrition, in patients receiving palliative care, 597 B Beers criteria, for high-risk medications in geriatric patients, 571, 572 Biomarkers, potential, for postoperative delirium in geriatric patients, 512 Body composition, pharmacokinetic changes with aging, 459 460 C Cardiac evaluation, preoperative, in geriatric patients, 474 Cardiopulmonary resuscitation, critical care issues in geriatric patients with, 555 Cardiopulmonary resuscitation (CPR), in patients receiving palliative care, 595 597 Cardiovascular system, critical care issues in geriatric patients, 553 555 arrhythmias, 553 554 Anesthesiology Clin 33 (2015) 607 615 http://dx.doi.org/10.1016/s1932-2275(15)00083-x anesthesiology.theclinics.com 1932-2275/15/$ see front matter ª 2015 Elsevier Inc. All rights reserved.
608 Index Cardiovascular (continued) cardiopulmonary resuscitation, 555 congestive heart failure, 554 555 coronary disease, 554 valvular disease, 554 effects of aging on physiology of, 449 451 Chronic pain, and opioids in geriatric surgical patients, 569 in older adults, 577 590 age-related differences related to pain, 578 581 assessment of, 581 582 management of, 582 587 Cognitive dysfunction, postoperative, in the elderly, 517 550 causes of, 537 539 comparison with other medically related/induced cognitive disorders, 527 definition, 518 524 how long it lasts, 524 526 prevention of, 539 540 risk factors for, 527 537 treatment of, 540 541 Cognitive improvement, postoperative, in the elderly, 526 527 Congestive heart failure, critical care issues in geriatric patients with, 554 555 Coronary disease, critical care issues in geriatric patients with, 554 Critical care issues, in geriatric patients, 551 561 cardiovascular system, 553 555 arrhythmias, 553 554 cardiopulmonary resuscitation, 555 congestive heart failure, 554 555 coronary disease, 554 valvular disease, 554 epidemiology and impact, 551 552 frailty, 557 neurologic system, 552 553 delirium, 553 pain, 552 553 pulmonary system, 555 respiratory failure, 555 renal system, 555 556 acute kidney injury, 555 556 urinary tract infection, 556 trauma, 557 558 assessment, 557 treatment, 557 558 triage, 557 D Delirium, critical care issues in geriatric patients with, 553 postoperative, in geriatric patients, 505 516 current controversies, 511 512 use of antipsychotics, 511 512 use of ketamine, 511
Index 609 diagnosis, 506 507 clinical features, 507 screening tools, 507 future considerations, 512 potential biomarkers, 512 management, 510 511 pathophysiology, 507 510 neuroinflammation, 508 oxidative stress, 508 510 risk factors, 506 Do-not-resuscitate orders (DNR), in patients receiving palliative care, 595 597 E Emergency surgery, general, anesthetic considerations in geriatric patients, 494 496 End of life care. See Palliative care. Endocrine system, effects of aging on physiology of, 454 455 Enhanced recovery after surgery, with perioperative surgical home, 440 Etomidate, pharmacologic considerations in geriatric patients, 461 Euthanasia, 597 598 F Fentanyl, pharmacologic considerations in geriatric patients, 463 Fractures, hip, anesthetic considerations in geriatric patients, 493 494 Frailty, critical care issues in geriatric patients, 557 in preoperative evaluation of geriatric patients, 476 477 Functional status, in preoperative evaluation of geriatric patients, 477 478 G Gabapentinoids, for geriatric surgical patients, 571 Gastrointestinal system, effects of aging on physiology of, 452 453 Geriatric anesthesia, 427 605 chronic pain in older adults, 577 590 age-related differences related to pain, 578 581 assessment of, 581 582 management of, 582 587 critical care issues in, 551 561 cardiovascular system, 553 555 epidemiology and impact, 551 552 frailty, 557 neurologic system, 552 553 pulmonary system, 555 renal system, 555 556 trauma, 557 559 for common procedures, 491 503 emergent general surgery, 494 496 general approach, 492 493 hip fractures, 493 494 transcatheter aortic valve replacement, 496 499
610 Index Geriatric (continued) history of, 427 437 ASA Committee on Geriatric Anesthesia, 428 429 ASA involvement, 433 early years, 428 future considerations, 433 434 involvement by American Geriatrics Society, 432 433 Society for Advancement of Geriatric Anesthesia, 429 432 pain management issues in, 563 576 Beers criteria for, 571 initiating treatment, 567 measurement of pain, 565 multimodal analgesia, 569 nonopioid adjuvants, 569 571 opioids, 568 569 physiologic changes in the older adult, 565 regional analgesic techniques, 571 574 risks of pain treatment, 564 palliative care in, 591 605 end-of-life and hospice, 595 integrating with perioperative care, 598 600 ongoing controversies in, 597 598 perioperative issues related to, 595 597 perioperative surgical home, 439 445 benefits of, 441 complications in the geriatric population, 443 444 definition, 440 441 future considerations, 443 444 in the aging patient population, 442 443 triple aim, 441 442 pharmacology, 457 469 applying knowledge to practice, 464 465 cerebral mechanisms of geriatric anesthesia, 458 459 consequences of overdosing in elderly patients, 465 considerations with specific medications, 460 464 pharmacokinetic changes with aging, 459 460 physiology considerations in, 447 456 cardiovascular system, 449 451 endocrine system, 454 455 gastrointestinal system, 452 453 nervous system, 448 449 renal and volume regulation system, 453 454 respiratory system, 451 452 postoperative cognitive dysfunction, 517 550 causes of, 537 539 comparison with other medically related/induced cognitive disorders, 527 definition, 518 524 how long it lasts, 524 526 prevention of, 539 540 risk factors for, 527 537 treatment of, 540 541
Index 611 postoperative cognitive improvement, 526 527 postoperative delirium, 505 516 current controversies, 511 512 diagnosis, 506 507 future considerations, 512 management, 510 511 pathophysiology, 507 510 risk factors, 506 preoperative assessment, 471 480 cardiac evaluation, 474 diagnostic tests, 478 479 frailty, 476 477 functional status, 477 478 medication history and polypharmacy, 478 neuropsychiatric evaluation, 472 474 nutritional status, 478 patient counseling, 479 pulmonary evaluation, 474 476 surgeon s perspective on optimal perioperative care, 481 489 ACS/AGS Best Practices Guidelines, 483 additions to best practices, 483 485 practical options for, 485 486 H Hip fractures, anesthetic considerations in geriatric patients, 493 494 History, medication, in preoperative evaluation of geriatric patients, 478 of geriatric anesthesia, 427 437 ASA Committee on Geriatric Anesthesia, 428 429 ASA involvement, 433 early years, 428 future considerations, 433 434 involvement by American Geriatrics Society, 432 433 Society for Advancement of Geriatric Anesthesia, 429 432 Hospice, and end-of-life care, 595 Hydration, in patients receiving palliative care, 597 I Inhalational anesthetics, pharmacologic considerations in geriatric patients, 460 461 Intensive care unit, surgical, integrating palliative care with perioperative care in, 598 599 Intensive care unit. See Critical care. K Ketamine, and postoperative delirium in geriatric patients, 511 M Mechanical circulatory support devices, palliative care consultation and, 599 600 Medication history, in preoperative evaluation of geriatric patients, 478
612 Index Meperidine, pharmacologic considerations in geriatric patients, 464 Metabolism, pharmacokinetic changes with aging, 460 Midazolam, pharmacologic considerations in geriatric patients, 463 Multimodal analgesia, in geriatric surgical patients, 569 N National Surgery Quality Improvement Program, of ACS, best practices guidelines for preoperative assessment of geriatric patients, 483 Nervous system, effects of aging on physiology of, 448 449 Neuraxial analgesia, in geriatric surgical patients, 574 Neuroinflammation, in postoperative delirium in geriatric patients, 508 Neurologic system, critical care issues in geriatric patients, 552 553 delirium, 553 pain, 552 553 Neuromuscular blocking drugs, pharmacologic considerations in geriatric patients, 464 Neuropsychiatric evaluation, preoperative, in geriatric patients, 472 474 Noninvasive ventilation, in patients receiving palliative care, 597 Nonsteroidal anti-inflammatory drugs (NSAIDs), for geriatric surgical patients, 570 571 Nutrition, artificial, in patients receiving palliative care, 597 Nutritional status, in preoperative evaluation of geriatric patients, 478 O Opioids, for geriatric surgical patients, 565 569 metabolism, 565 567 pharmacologic considerations in geriatric patients, 463 464 Overdosing, of anesthetics in geriatric patients, 465 Oxidative stress, in postoperative delirium in geriatric patients, 508 510 P Pain management, for chronic pain in older adults, 577 590 age-related differences related to pain, 578 581 assessment of, 581 582 management of, 582 587 for geriatric surgical patients, 563 576 Beers criteria for, 571, 572 initiating treatment, 567 measurement of pain, 565 multimodal analgesia, 569 nonopioid adjuvants, 569 571 acetaminophen, 569 570 gabapentinoids, 571 NSAIDs, 570 tramadol, 570 571 opioid metabolism, 565 567 opioids, 568 569 physiologic changes in the older adult, 565 regional analgesic techniques, 571 574 neuraxial techniques, 571 574
perineural blocks, 571 573 risks of pain treatment, 564 Pain, chronic, in the geriatric critical care patient, 552 553 Palliative care, for geriatric anesthesiologists, 591 605 definition, 593 595 end-of-life and hospice, 595 integrating with perioperative care, 598 600 and mechanical circulatory support devices, 599 600 in the surgical intensive care unit, 598 599 ongoing controversies in, 597 598 euthanasia, 597 598 palliative sedation, 597 598 physician-assisted suicide, 597 598 perioperative issues related to, 595 597 CPR, DNR orders, and anesthesiology, 595 597 hydration and artificial nutrition, 597 noninvasive ventilation, 597 Pathophysiology, of postoperative delirium in geriatric patients, 507 510 neuroinflammation, 508 oxidative stress, 508 510 Perineural blocks, in geriatric surgical patients, 571 573 Perioperative care, of geriatric patients, surgeon s perspective on optimal, 481 489 ACS/AGS Best Practices Guidelines, 483 additions to best practices, 483 485 practical options for, 485 486 Perioperative surgical home, geriatrics and, 439 445 benefits of, 441 complications in the geriatric population, 443 444 definition, 440 441 future considerations, 443 444 in the aging patient population, 442 443 triple aim, 441 442 Pharmacology, geriatric, 457 469 applying knowledge to practice, 464 465 cerebral mechanisms of geriatric anesthesia, 458 459 consequences of overdosing in elderly patients, 465 considerations with specific medications, 460 464 etomidate, 461 462 inhalational anesthetics, 460 461 midazolam, 463 neuromuscular blocking agents, 464 opioids, 463 464 propofol, 461 thiopental, 463 pharmacokinetic changes with aging, 459 460 body composition, 459 460 metabolism, 460 Physician-assisted suicide, 597 598 Physiology, considerations in geriatric patients, 447 456 and pain management for surgery, 563 576 cardiovascular system, 449 451 Index 613
614 Index Physiology (continued) endocrine system, 454 455 gastrointestinal system, 452 453 nervous system, 448 449 renal and volume regulation system, 453 454 respiratory system, 451 452 Polypharmacy, in preoperative evaluation of geriatric patients, 478 Postoperative cognitive improvement. See Cognitive improvement, postoperative. Postoperative delirium. See Delirium, postoperative. Preoperative assessment, of geriatric patients, 471 480 cardiac evaluation, 474 diagnostic tests, 478 479 frailty, 476 477 functional status, 477 478 medication history and polypharmacy, 478 neuropsychiatric evaluation, 472 474 nutritional status, 478 patient counseling, 479 pulmonary evaluation, 474 476 Preoperative evaluation, of geriatric patients, ACS NSQIP/AGS best practices guidelines for, 483 Propofol, pharmacologic considerations in geriatric patients, 461 Pulmonary evaluation, preoperative, in geriatric patients, 474 476 Pulmonary system, critical care issues in geriatric patients, 555 R Regional analgesia, for surgery in geriatric patients, 571 574 neuraxial, 574 perineural blocks, 571 573 Remifentanil, pharmacologic considerations in geriatric patients, 463 464 Renal system, critical care issues in geriatric patients, 555 556 acute kidney injury, 555 556 urinary tract infection, 556 effects of aging on physiology of, 453 454 Respiratory failure, critical care issues in geriatric patients with, 555 Respiratory system, effects of aging on physiology of, 451 452 S Sedation, palliative, controversy over, 597 598 Society for the Advancement of Geriatric Anesthesia (SAGA), role in history of geriatric anesthesia, 429 432 Suicide, physician-assisted, 597 598 Surgeons, perspective on optimal perioperative care of geriatric patients, 481 489 ACS/AGS Best Practices Guidelines, 483 additions to best practices, 483 485 practical options for, 485 486 Surgery, anesthesia for common procedures in geriatric patients, 491 503 emergent general surgery, 494 496 general approach, 492 493
Index 615 hip fractures, 493 494 transcatheter aortic valve replacement, 496 499 geriatric, perioperative surgical home, 439 445 benefits of, 441 complications in the geriatric population, 443 444 definition, 440 441 future considerations, 443 444 in the aging patient population, 442 443 triple aim, 441 442 Surgical intensive care unit, integrating palliative care with perioperative care in, 598 599 T Thiopental, pharmacologic considerations in geriatric patients, 463 Transcatheter aortic valve replacement, anesthetic considerations in geriatric patients, 496 499 Trauma, critical care issues in geriatric patients, 557 558 assessment, 557 treatment, 557 558 triage, 557 Triple aim, with perioperative surgical home, 441 442 U Urinary tract infections, critical care issues in geriatric patients with, 556 V Valvular disease, critical care issues in geriatric patients with, 554 Ventilation, noninvasive, in patients receiving palliative care, 597