老年病人的麻醉管理演示幻灯片.pptVIP

Anesthetic Management of the Elderly Patient;Hayflick’s View of Aging;# Older Americans;;The Oldest…..;Life Expectancy at birth USA - 1997;Life Expectancy, Life Span, Maximum Length of Life;Oldest Surgical Patient?Oliver. Br J Anaesth 2000; 84:260;# Anesthetics per 100 Population?Clergue. Anesthesiology 1999; 91:1509 (France);Vascular Surgery – Mortality vs AgeFleisher. Anesth Analg 1999; 89:849;Why Obtain Preoperative Tests?;Value of Preoperative Testing Before Low Risk SurgerySchein. N Engl J Med 2000; 342:168;Value of Preoperative Testing Before Low Risk Surgery Schein. N Engl J Med 2000; 342:168;Intermediate Risk Noncardiac Surgery (Mortality 1%, 5%);Preoperative Tests - Prevalence of Abnormal Results544 consecutive intermediate risk non-cardiac surgical patients 69 yrs - Dzankic. Anesth Analg 2001; 93:301;Outcomes of Patients with No Laboratory Assessment for Intermediate Risk Surgery N = 1,044 Narr. Mayo Clin Proc 1997; 72:505;Is ROUTINE Preoperative Testing Indicated?;No Non-invasive or Invasive Cardiac Testing for Intermediate Risk Surgery;INTERMEDIATE CLINICAL PREDICTORS;FUNCTIONAL CAPACITY ;Estimated Energy Requirements for Activities of Daily Living - 1;Estimated Energy Requirements for Activities of Daily Living - 2;Most Difficult ROUTINE Preoperative Tests to Justify ;4 Statin Myopathic SyndromesThompson. JAMA 2003; 289:1681;% of Older Patients with Diastolic Dysfunction;Diabetes Mellitus – 8.7% of Elderly;Problems with Oral Hypoglycemic AgentsGu. Anesthesiology 2003; 98:1359;Diabetes Mellitus – Tight Control of Glucose Gu. Anesthesiology 2003; 98:1359;Beta-adrenergic Blocking Agents – Perioperative Administration;Perioperative Myocardial IschemiaWallace. Anesthesiology 1998; 88:7;Perioperative Beta-Blockade - Therapeutic Target Auerbach. JAMA 2002; 287:1435;Actual Practice versus Evidenced-based Beta-blockade – “Wrong” Answers from ABA Oral Examinees;General Anesthesia;MAC AgeNickalls. Br J Anaesth 2003; 91:170;Nitrous