Risks of anesthesia in different age groups | Risks of anesthesia

Risks of anesthesia in different age groups

With increasing age, the risks of anesthesia or surgery also increase. The risks of anesthesia in old age are mainly characterized by the numerous comorbidities of the respective patient. In the foreground are diabetes mellitus, high blood pressure, pronounced cardiac insufficiency, lung disease, and reduced liver and kidney function.

These can lead to the fact that certain anaesthetics may not be given at all and that it is necessary to switch to alternatives. A problem specific to anaesthesia after an operation is postoperative delirium. Patients over 60 are particularly affected and appear confused and disorientated.

The sleep-wake cycle and memory can also be affected. To prevent this, regional anaesthesia methods can be used instead of general anaesthesia, as these do not act in the brain and therefore have a lower risk of such side effects. Other common complications in older people after surgery are wound healing disorders, thromboses, embolisms and infections.

Due to these risks, both the preparation for surgery and the follow-up care and monitoring is more intensive in the elderly than in young, healthy patients. The risks of anesthesia in an infant primarily concern the securing of the respiratory tract. Here, on the one hand, work should be done quickly, as infants have a smaller reserve of oxygen and “desaturate” more quickly.

On the other hand, this step is made more difficult by the small, narrow airways. If an infant is introduced with inhaled anesthetics, the high sensitivity of the rapid increase in concentration should be used to counteract a possible breakdown of the circulation. In addition to securing the airway, the maintenance and supply of warmth is essential for the infant, as hypothermia can quickly occur.

A further risk is the tolerance and correct dosage of the anaesthetics, which, however, is individually adapted and carried out by trained personnel. Depending on the surgical procedure, an additional risk of anaesthesia may arise. Since anaesthesia is indispensable for certain operations in an infant, its benefits should not be neglected.

Since there may also be individual risks in an infant, it is best to ask the anesthesiologist if there are any further questions. In any case, a detailed explanation is given by a physician before any intervention. First of all, it should be made clear that an infant cannot be compared to a small adult, so not all risks of an anaesthesia in an adult can be transferred one-to-one to an infant.

On the one hand, the organs of an infant are not yet fully developed, which is important to know when administering medication. On the other hand, the metabolic situation of an infant must be taken into account. Malformations of the oral and maxillary apparatus, for example in Pierre-Robin syndrome or an enlarged tongue in Down syndrome, can already cause difficulties in ventilation and intubation.

In addition, a recent infection of the respiratory tract can pose a risk of anesthesia in infants, as the bronchial tubes can become more irritable and cramp, making ventilation more difficult. In addition, the high demand for heat during anesthesia must be considered and covered in order to avoid associated complications. The consumption of fluids and nutrients must also be individually controlled and administered to avoid possible hypoglycaemia or dehydration.

Even more important than in adults is the supply of oxygen. The time between oxygenation of the blood and connection of the ventilator should therefore be kept very short, since a small child desaturates much faster than an adult. In addition, there are the risks of the surgical procedure itself, which can have an additional effect on the course of the anesthesia. Of course, the anesthesiologists know about the specific risks of anesthesia and can adjust accordingly before surgery, so that the risks are generally kept relatively low.In addition, a detailed discussion with an anesthesiologist takes place in advance to inform about the risks of anesthesia, and there is always time for questions.