Anesthetic Management in Geriatric and Comorbid Patients: Clinical Challenges, Risk Stratification, and Outcome-Oriented Strategies

Abstract

The increased life expectancy across the world has resulted in an increasing number of geriatric patients attending surgical procedures with a multitude of comorbidities. Advancing physiological changes, changes in pharmacodynamics and pharmacokinetics, cognitive frailty, and riskiness in the perioperative period are all linked to ageing. Additional complications such as multimorbidity and polypharmacy make these changes very difficult to deal with during anaesthetic management. These are the outcome-based factors of anaesthetic care in geriatric and comorbid patients that have been thoroughly presented in this article. It references anesthesiology, geriatrics, perioperative medicine, and public health based evidence in assessing age-related physiological alterations, risk stratification models, choice of anaesthetic technique, issues related to intraoperative management, and optimization of postoperative outcomes. The cognitive complications, frailty, and patient-centred outcomes are given a special emphasis. New opportunities of digital health, artificial intelligence, and precision medicine in geriatric anaesthesia are also explained. The article concludes that the outcome-oriented, multidisciplinary, and individualised approach to geriatric and comorbid patients perioperative care is safe and effective.

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