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Pharmakologische Besonderheiten und Probleme des älteren Patienten

Pharmacological peculiarities and problems with older patients

  • Klinische Pharmakologie
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An Erratum to this article was published on 15 December 2015

Zusammenfassung

Aufgrund der demographischen Entwicklung ist damit zu rechnen, dass der Bevölkerungsanteil mit einem Lebensalter von über 65 Jahren bis ins Jahr 2025 auf 20% angestiegen sein wird und 2030 in Deutschland im Vergleich zu heute doppelt so viele Menschen dieser Altersgruppe leben werden. Dies hat gerade auch auf anästhesiologische Anforderungen weit reichende Auswirkungen. Zusätzlich zu der bei dieser Patientengruppe häufig vorhandenen Multimorbidität spielen altersbedingte physiologische Veränderungen in der gesamten perioperativen Versorgung eine wichtige Rolle. Im Vordergrund stehen degenerative Veränderungen, die sich auf respiratorische, kardiovaskuläre, renale und hepatische Funktionen konzentrieren. Neben kardiopulmonalen oder operativen Komplikationen stellt v. a. die postoperative kognitive Dysfunktionen (POCD) eine Hauptkomplikation beim alten Menschen dar, die auch eine volkswirtschaftliche Relevanz mit sich bringt. Regionalanästhesie bietet verglichen mit Allgemeinanästhesie gerade auch beim alten Patienten gewisse Vorteile. Dies bezieht sich hauptsächlich auf ein geringeres Risiko für thrombembolische und respiratorische Komplikationen.

Abstract

Because of demographic developments, the fraction of the German population over 65 years of age in the year 2025 will have risen to 20% and will continue to rise so that in 2030 this number will have doubled compared to today’s numbers. This has a huge impact on the requirements for anaesthesiologic procedures. In addition to the frequent multi-morbidity in this age group, physiologic changes also occur in the elderly which have to be taken into consideration during the entire perioperative management of these patients. Renal, cardiovascular and hepatic function are impaired in many elderly patients. A major concern in addition to cardiovascular and operative complications is the postoperative cognitive dysfunction (POCD), not only because of its implications for the patient but also because of economical consequences. Regional anaesthesia has some benefits when compared to general anaesthesia as it leads to a reduction in thromboembolic and respiratory complications.

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Authors and Affiliations

  1. Klinik für Anästhesie und Intensivtherapie, Klinikum der Philipps-Universität, Marburg

    C. D. Kratz & G. Geldner

  2. Institut für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum, Mannheim

    T. Iber

  3. Klinik u. Poliklinik für Anästhesiologie und Intensivtherapie, Universität, Rostock

    A. Schleppers

  4. Klinik für Anästhesie und Intensivtherapie, Klinikum der Philipps-Universität, Baldingerstraße, 35043, Marburg

    C. D. Kratz

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  1. C. D. Kratz
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  2. A. Schleppers
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  3. T. Iber
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  4. G. Geldner
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Correspondence to C. D. Kratz.

Additional information

Ein Erratum zu diesem Beitrag ist unter http://dx.doi.org/10.1007/s00101-015-0116-5 zu finden.

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Kratz, C.D., Schleppers, A., Iber, T. et al. Pharmakologische Besonderheiten und Probleme des älteren Patienten. Anaesthesist 54, 467–475 (2005). https://doi.org/10.1007/s00101-005-0810-9

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