| A Clinical Review of Geriatric Anesthesia - an Analysis of 601 Cases . |
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Kang Woo Lee, Man Sik Yang, Yoon Gie Min, Byung Jo Choi |
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Department of Anesthesiology, Han Kang Sung Shim Hospital, Seoul, Korea. |
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| Abstract |
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A total of 601 anesthesias given to the patients over age 60 who were admitted to Han Gang Sung Shim Hospital during the period from Jan. 1976 to Dec. 1980, were subjected to this clinical review. 1) Of the total 15,609 cases, 601 cases(3.8%) were over 60 years of age consisting of 315 male(52.4%) and 286 female(47.6%). 2) Among the 601 geriatric patients, 453 cases were 60~69 years of age(75.4%), 128 cases were 70~79 years of age(21.3%) and 20 cases were over 80 years of age(3.3%). 3) In the surgical group, 358 cases(59.7%) were general surgery, 120 cases(20.0%) were orthopedic surgery, 34 cases(5.6%) were urology, 20 cases(3.3%) were gynecology respectively. 4) The techniques of anesthesia were 545 cases(90.7%) of general anesthesia, 22 cases(3.7%) of spinal anesthesia and 17 cases(2.8%) of axillary block. 5) Anesthetics were diethly-ether 24 cases(36.3%) and halothane 22 cases(33.3%) in 1976. But there were 5 diethly-ether cases(0.3%) and 120 halothane cases(91.6%) in 1980. 6) For the duration of anesthesia, 81 cases(13%) were within 1 hour, 238 cases(39.6%) within 2 hours, 156 cases(26.0%) within 3 hours and 21 cases over 5 hours. 7) In the classification of physical status of the geriatric patients, 42 cases(7.0%) were class l, 201 cases(33.2%) were class ll, 109 cases (18.1%) were class lll and 8 cases(1.3%) were class lV. 8) Emergency cases were 223 cases(37.1%) and 378 cases(62.9%) were elective. 9) The findings of preoperative chest X-rays revealed that 227 cases(48.8%) were within normal limits, 56 cases(12.0%) had hypertensive heart disease, 24 cases(5.1%) had senile fibrosis, 22 cases(5.1%) had unstabilized tuberculosis and 14 cases(3%) had pneumonis. 10) In the preoperative R.K.G., which covered 50% of the patients, 115 cases(38.3%) were within normal limit, 41 cases(13.6%) showed L.V.H., 30 cases(10.0%) had sinus bradycardia, 13 cases (4.3%) had myocardial lschemia and 7 cases(2.3%) had R.B.B.B. 11) Post-operative mortality rate was 5.8% in 1976, 4.0% in 1977, 3.6% in 1978 and 2.1% in 1980, and over all mortality rate was 3.1%. |
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