Anaesthesia in the elderly with special reference to management of orthopaedic patients

Elderly patients are placing increased demands on the health care resources in Kenya. The population of old patients has increased and complex surgical/orthopaedic procedures are being done on old patients. Due to the normal physiological alterations that occur with age, as well as the effects of common chronic diseases, elderly patients are less resilient than younger patients and are at risk of developing a variety of intraoperative and postoperative complications peculiar to their age. If and when complications develop in the elderly patients they have no reserves to withstand them and recovery is prolonged. In this article we review the factors that affect the peri-anaesthetic patients with special reference to orthopaedic and trauma elderly patients and we highlight the factors that may modify the treatment and surgery in these patients. We also recommend modifications for developing countries to lessen the financial burden on health care units.