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KMID : 0380319920500000131
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Journal of Korean Research Institute for Better Living
1992 Volume.50 No. 0 p.131 ~ p.144
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Clinical Study of Geriatric Anesthesia in Patients over 80 Years Old
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Abstract
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With clinical anesthetic and admission records of 161 geriatric patients over 80 years of age from Jamuary 1986 until December 1991 at the anesthetic department of Ewha Women´s University Hospital, laboratory findings before and after the anesthesia, cardiovascular changes, postoperative complications and mortality rates were statistically analyzed annually, between departments, according to anesthetic techniques of anesthetic agents and following results were obtained.
1. Of the total number of anesthesia, 27086 cases, the number of patients over 65 years of age was 1446(5.34％) and that over 80 years of age was 161(0.59％) both of which increased annually.
2. Comparing between department, the order of greatest number of cases was as follows : 65 cases of urology department, 40 cases of orthopedic surgery and 39 cases of general surgery department.
3. Comparing between anesthetic technique, the number of general anesthesia was 118(73.3％) and that of regional anesthesia was 43(26.7％). The number of balanced anesthesia was 70(43.5％) making the majority of the general anesthesia and the number of epidural among the regional anesthesia was 33(20.5％) which increased in the nineties.
4. Comparing between the combined diseases, the number of hypertension was 37(23.0％) making the majority of the cardiovascular disease and the number of chronic obstructive lung disease was 15(9.3％) among the pulmonay disease.
5. Abnormal findings of EKG was reported in 96 cases(59.8％) out of 161 cases. The order of most frequent findings was as follows ; myocardial ischemia 53 cases(39.3％), left ventricular hypertrophy 15 cases(11.4％) and atrial fibrillation 14 cases(10.6％).
6. Abnormal chest X-ray findings was found in 85 cases(52.8％) out of 161 cases. The order of most frequent findings was as follows : hypertensive heart configuration 27 cases(13.1％) and senile fibrosis 11 cases(12.1％).
7. Preoperative hematologic labolatory tests showed hypoalbuminemia as the commonest with 36 cases(19.9％). Decrease in total protein and increase in BUN were 32 cases(19.9％) respectively. The number of hyperglycemia was 21(13.0％).
8. Under general anesthesia, blood pressures before induction of anesthesia, after endotracheal intubation, after extubation, before transport from recovery room to ward showed significant increase compared to that measured at ward, but the lowest blood pressure during the operation was significantly lower. Heart rate remained increased significantly higher than that measured at ward. Under regional anesthesia, blood pressure increased significantly before induction of anesthesia compared to that measured at ward, but the lowest blood pressure during surgery was significantly lower. Heart rate increased significantly only at the lowest blood pressure under regional anesthesia.
9. Of postoperative complications, the number of hypoxemia was 4(28.6％) and that of mental change was 3(21.5％) which were themajority of the cases.
10. Postoperative mortality data showed 7 cases which occured within 7 days after surgery and the most common cases cerebrovascular accident with 6 cases.
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