Tuesday, December 12

Fitness For Surgery in Elderly

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But, in any instance, it would not be possible to drag an elderly patient into surgery without doing a complete and thorough physical assessment prior or pre-op to the surgical procedure.

Why is it necessary?

In the elderly age group, many individuals will be suffering from different disease conditions and among them diabetes, hypertension, asthma as well as heart diseases are quite common. Apart from these, many patients are on medication which could affect a surgical procedure. One of the examples would be drugs like aspirin and clopidogrel affecting blood clotting of an individual. Along with these, various physical distortions as well as functional limitations will put a hold to certain surgical procedures and would necessitate use of different options.

Sometimes, alongside the surgical procedure, age related disorders affect mainly to the anesthetic decision. Thus, giving general anesthesia to a patient suffering from certain types of heart diseases or respiratory diseases could be dangerous and alternative methods may have to be considered.

Self assessment for fitness:

An individual will be able to do a self assessment in order to undergo surgery to a limited extent. In instances where the individual is suffering from fever, asthmatic attack or even a bad cold, the person is not 100% fit to undergo immediate surgery unless it’s an emergency procedure.

Knowing what drugs are being taken is another tool to assess fitness as some drugs, as mentioned before, will adversely affect surgical procedures. Thus, having a basic knowledge of such drugs would be useful in making a self-assessment.

Past history will also benefit in making an assessment of fitness and if there was a delay in regaining consciousness before, it would be wise to inform the anesthetist as well as the surgeon beforehand.

Assessment proper:

Usually the pre-op assessment would be done by the anesthetic doctor and will include detailed history taking, physical examination as well as a set of investigations. These investigations can include Fasting blood sugar, Full Blood Count, ECG, Chest X-ray, Renal functions, Clotting profiles as well as other related investigations depending on the surgical procedure as well as the patient.

If these tests are found to be satisfactory along with the clinical condition, an anesthetist would verify the fitness for surgery and would advise the surgeon to continue with the surgery while taking necessary precautions to prevent any complications.

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