Medical Practice Technical Challenges


Tailored Anaesthesia for the Elderly Patient

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May 3rd 2023 - May 24th 2023
Diana Henriques (MD) , 
Diogo Martins (MD) , 
Helena Gomes Santos (MD) , 
Ria Lakhani (MD)
This course intends to equate and demonstrate the relevance of multiple aspects of perioperative medicine in the elderly patient - a surgical population with increasing representation.
The structure of the course will highlight the multidisciplinary approach required for a better understanding of the topic, highlighting the physiological impact of the aging adult for anaesthesia and surgery.

The course initially highlights the preoperative evaluation, consequences of diminishing multiorganic functional capacity, the possibilities for preventing complications (namely cognitive disorders) and the multiplicity of comorbidities with inherent polymedication.

The third and final phase of the course aims to articulate points discussed above, with the postoperative period. The course will focus on the discussion of complications during this period, the mitigation of post-operative pain, level of care required during this period (admission to ICU) and the ethical values that must prevail during decision-making, demonstrating not only the perspective of the anaesthesiologist but also that of the surgeon and intensivist.
Doctors: Anaesthesiologist Residents, Anaesthesiologists, Surgeons, Geriatricians

Nurses: With an interest in Geriatrics
  1. Recognise the importance and specificity of pre-operative assessment of the geriatric patient as a multidimensional and interdisciplinary process, focused on determination of psychological demeanor, physiological clinical status and quantification of functional residual capacity
  2. Understand and identify the particular pharmacokinetic and pharmacodynamic limitations of the elderly patient.
  3. Identify and optimise modifiable risk factors before surgery in order to improve surgical outcome for the patient.
  4. Elaborate and justify the proposed modality of hospital admission for the elderly patient.
  5. Discuss the most appropriate anaesthetic techniques for the elderly patient.
  6. Recognise and enumerate interactions between the process of ageing, pathophysiological impact of anaesthetic drugs on the organism.
  7. Understand the concept of tailored anaesthesia.
  8. Prioritise actions during the postoperative period with real impact on global prognosis of the patient.
  9. Recognise the most frequent complications during the postoperative period and understand how to prevent them as the main concern.
  10. Discuss and plan for appropriate levels of care during the postoperative period, accounting for factors discussed during the course.
  11. Understand the stepwise approach of decision-making during the preoperative period with the various stakeholders, and how this process leads to the desired results. Understand the particular role of the anaesthesiologist during this process.
  12. Promote a global vision of the challenges when approaching an elderly patient for surgery, using the knowledge acquired during the course and actively participating in decision-making during various proposed clinical cases.