Cerebral haemodynamics, anaesthesia and the frail brain
Sam Barnes, Lucy Beishon, Md Tanvir Hasan, Thompson Robinson, Jatinder S. Minhas
Abstract
The global population is ageing, and by 2030, one in six people will be aged over 60 worldwide [ 1 ]. As a result, the number of older people requiring both routine and emergency anaesthesia for surgical procedures is expected to rise significantly [ 2 ]. This poses a number of challenges given that both the prevalence and degree of multi-morbidity, functional and cognitive impairment, and polypharmacy increase with age [ 2 ]. All of these factors lead to higher levels of risk, both in terms of surgery itself and the inherent risk of the accompanying anaesthetic [ 2 ]. As a result, there has been a rise in the number of perioperative services for older people, which aim to identify medical comorbidities, establish the level of risk, and pre-optimise older people undergoing both emergency and elective procedures [ 2 ].