Too old for ambulatory anaesthesia? Management of ambulatory anaesthesia in elderly adults

As the elderly population continues to grow and their physiological reserves decline, perioperative morbidity and mortality are increasing, consequently. A significant proportion of these patients are frail, which further elevates their risk of postoperative complications and adverse outcomes. At the same time, technological and surgical advancements have expanded the scope of procedures that can be safely performed in ambulatory settings, making it possible for many common surgeries in elderly patients to be conducted on an outpatient basis.

Recent studies and guidelines confirm that ambulatory surgery is a safe and effective option for many procedures, including in older adults. Benefits include quicker recovery times and a reduced incidence of perioperative neurocognitive disorders compared with inpatient surgery. However, these advantages rely on thorough preoperative evaluation, particularly in frail elderly patients. Comprehensive assessments, including cognitive, nutritional, and standard anaesthesiologic evaluations, are essential to ensure patient safety and to optimise outcomes.

This review summarises current literature on the management of elderly patients undergoing ambulatory surgery, emphasising the importance of individualised preoperative assessment and patient selection.