Introduction

The use of anesthetics presents greater risks for the elderly than for younger persons; recovery from the drugs is longer, and complications may be more severe. Also, many age-related anatomic, physiologic, and functional changes (eg, decreases in height, weight, body surface area, and metabolism) affect the use of anesthetics--see Table 27-1. (see also page 56) Commonly used measurements of organ function (eg, cardiac index, oxygen consumption, glomerular filtration rate) are decreased in the elderly, but these decreases correlate with an age-related decrease in tissue mass. Also, the function of the liver and kidneys, which are involved in drug metabolism, often decreases in the elderly; as a result, clearance of many drugs, including several commonly used anesthetics (see Table 27-2), is decreased.