The autonomic nervous system and geriatric anesthesia.
Patients subjected to surgery and anesthesia must rely on autonomic mechanisms to maintain homeostasis and adequate organ perfusion. In the elderly, many of these mechanisms are limited in the strength, the rapidity, and the range in which they can compensate for physiological stresses and trespass. Anesthesiologists rely on predictable results from manipulation of the ANS and its effector organs, but aging in itself seems to alter the responses to these pharmacological manipulations. The diseases and medications that often accompany old age are further confounding factors. Some of the changes found with age seem to arise from the ANS itself, while some more likely originate in structural alterations of the cardiovascular system. Although both basic and clinical research reports are rife with contradictions, a knowledge of ANS aging should help us to anticipate the particular responses and requirements of our older patients.
Tasch
M D
MD
Department of Anesthesia, Indiana University School of Medicine, Indianpolis 46223.
D000368:Aged; D000375:Aging / Q000502:physiology; D000758:Anesthesia; D001341:Autonomic Nervous System / Q000502:physiology*; D005853:Geriatrics; D006801:Humans