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Pharmacological Considerations for the Use of General Anesthetics in the Elderly

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General Anesthesia Research

Part of the book series: Neuromethods ((NM,volume 150))

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Abstract

Aging is a physiological condition involving progressive degenerative modifications and loss of functionality in all organ systems. In general, aged patients are frail and sensitive to anesthesia and surgery. Clinical practice indicates that being more sensitive to anesthetic drugs and more susceptible to the side effects, elderly requires usually lower doses to reach the clinical anesthesia. This is mainly associated with the significant changes in pharmacokinetics (and pharmacodynamics) occurring with advancing age. However, how the dose–response relationship is affected by age should be better defined. This chapter focuses on the main changes that physiologically occur with age, how these changes affect organs and systems, and their impact on anesthetic care. The agents used in general anesthesia are discussed in detail with particular emphasis on aspects concerning the dose, safety, and efficacy of their use in the elderly. Moreover, we highlight some recent preclinical evidence on the use of general anesthetics in aged animals.

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Author information

Authors and Affiliations

  1. Division of Pharmacology, Department of Experimental Medicine, University of Campania “L. Vanvitelli”, Naples, Italy

    Francesca Guida, Enza Palazzo, Serena Boccella, Livio Luongo, Ida Marabese, Vito de Novellis & Sabatino Maione

  2. Villa Esther Hospital, Avellino, Italy

    Giulio Scala

  3. Università Campus Bio-Medico, Rome, Italy

    Francesca Gargano

  4. Department of Plastic Surgery, University of Campania “L. Vanvitelli”, Naples, Italy

    Gorizio Pieretti

  5. Department of woman , children, general and specialistic surgery, University of Campania “L. Vanvitelli”, Naples, Italy

    Mariantonietta Scafuro

Authors
  1. Francesca Guida
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  4. Livio Luongo
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  10. Vito de Novellis
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  11. Sabatino Maione
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Correspondence to Sabatino Maione .

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Editors and Affiliations

  1. Istituto Nazionale, Tumori - IRCCS - Fondazione Pascale, Napoli, Italy

    Marco Cascella

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Guida, F. et al. (2020). Pharmacological Considerations for the Use of General Anesthetics in the Elderly. In: Cascella, M. (eds) General Anesthesia Research. Neuromethods, vol 150. Humana, New York, NY. https://doi.org/10.1007/978-1-4939-9891-3_8

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  • DOI: https://doi.org/10.1007/978-1-4939-9891-3_8

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  • Publisher Name: Humana, New York, NY

  • Print ISBN: 978-1-4939-9890-6

  • Online ISBN: 978-1-4939-9891-3

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