Retrospective analysis of the anesthesia applications on outside the operating room geriatric patients

PURPOSE: With this study, we intended to analyze anesthetic practices and techniques used, and the complications which arose in geriatric patients (>65 year) in Dokuz Eylül University School of Medicine (DEUSM).MATERIALS AND METHODS: For this study, after obtaining permission of DEUSM Clinical and Laboratory Research Ethics Board, among 16045 patients, 3012 geriatric patients who received anesthesia outside the operating room between January 2003 and December 2011 were retrospectively analyzed from anesthesia records. Anesthesia methods (sedation, spinal anesthesia, intra tracheal general anesthesia, combined spinal epidural anesthesia, monitored anesthesia care), descriptive statistics (age, weight, operation time, gender, ASA classification, drugs made, operation type, complications (desaturation, pain of injection, nausea ? vomiting, aspiration, hypotension, bradycardia, perforation, others) were analyzed.RESULTS: Demographic characteristics of the cases were not statistically significant (p>0.05). The mean age and the mean body weight of the cases who developed intra- and post-operative complications were 73.35 ± 5.88 (65-89 years) and 71.07 ± 10.80 kg (42-120 kg), respectively. The mean anesthesia time of the cases was 69.98±55.44 min (15-440 min). There was a statistical relationship between hypotension and gender (p<0.05). Hypotension was observed in 29 (%1.7) male patients and in 7 (%0.5) female patients. There was a statistical relationship between ASA classification and bradycardia, sedation and complication, ITGA and complication (p<0.05). There was not a statistical relationship between emergency or electivity and complication, spinal anesthesia and complication, CSE anesthesia and complication (p>0.05).CONCLUSIONS: No major complication, morbidity or mortality was observed in the 3012 geriatric patients of total 16045 patients who had anesthesia outside the operating room in this study. If the results are analyzed in terms of complications, a relationship is observed only between gender and hypotension. Furthermore we found a statistical relationship between ASA classification and bradycardia. In geriatric patients the number of complications was in correlation with ASA classification. There was a statistical relationship between sedation, ITGA and complication.DISCUSSION: Preoperative cognitive and physical evaluations of geriatric patients outside the operating room conditions are very important. Accompanying illnesses must be detected and cured with appropriate physical, laboratory and radiological examinations before anesthesia applications. The anesthesia method to be implemented must be determined after these evaluations in accordance with the features of the procedure.In outside the operating room anesthesia conditions evaluation of the preoperative cognitive and physical conditions of geriatric patients is very important. With appropriate physical, laboratory and radiological examinations accompanying illnesses must be recognized and cured before anesthesia applications. Anesthesia practice must be determined after these examinations.