The Effects of General Anesthetics in Elderly Women

The prospect of being put to sleep with general anesthesia often brings anxiety to those anticipating surgery, but anesthesia is a highly advanced medical science with well-trained personnel, and the likelihood of problems occurring is quite small. The elderly might be concerned about how anesthesia will affect them if they have other medical conditions like heart disease, lung disease or diabetes, but the doctor and anesthesiologist will take additional precautions for safety.

Identification

• General anesthesia is a routine medical practice in which drugs are administered to the patient to induce a loss of consciousness during surgical procedures. It has three components: hypnosis (unconsciousness), relaxation (lack of muscle reflex) and analgesia (blockage of pain). Anesthesia is achieved through a careful combination of medications that are monitored throughout the anesthetic process.

Features

• Typically, an anti-anxiety medication is given in the preoperative waiting area to relax the patient and reduce anxiety. In the operating room, an inhalation or injection of anesthesia is given, which puts the patient into a deep sleep in advance of the surgical procedure. This deep state of sleep is monitored carefully with heart, blood pressure and respiration monitors. After surgery, the patient is taken to the recovery room and carefully watched until all effects of the anesthesia wear off.

Considerations

• There are special concerns when administering anesthesia to the elderly, in particular underlying conditions such as diabetes and heart and lung disease. A lifetime of smoking might have damaged the lungs, and vascular structures in the heart might not be as elastic as in younger people. Anesthesia also can affect blood pressure in the elderly, and problems managing blood sugar in elderly diabetics can add hazards to general anesthesia. In addition, some evidence shows that there might be cognitive problems in the elderly after anesthesia, but these are generally short-lived. All of these conditions require careful consideration in choosing the right anesthetic.

Special Concerns for Women

• Women might have a slightly different response to anesthesia than men, according to a 1999 Duke University study. Researchers found that women woke up more quickly from general anesthesia and that they require larger amounts of some types of anesthesia. Women also might have more nausea from anesthesia, possibly due to the types of surgery that is done, such as breast and gynecological surgery. Your anesthesiologist will be aware of these differences and will adjust doses accordingly.

Prevention/Solution

• To ensure that your experience with anesthesia is a safe one, make sure your physician is aware of all of your medical conditions and the medications you are taking. Doctors should also be aware of any herbal or nutritional supplements you are taking in case they produce an effect in combination with anesthesia drugs. Notify your physician of any allergies. Alert your anesthesiologist to any loose teeth or dentures that might be broken during administration of anesthesia. Report any previous reactions to anesthesia. If there is a family history of problems with anesthesia, make sure your physician and anesthesiologist are aware. Do not smoke before any procedure that involves general anesthesia, and follow pre-surgery instructions about refraining from food or drink.