Anaesthesia and the elderly.

The peri-operative management of elderly patients presents a variety of problems to the anaesthetist. These include organ dysfunction associated with the ageing process and the high incidence of serious disease affecting major organ systems. In addition, elderly patients commonly require multiple drug therapy. As such they are likely to suffer adverse drug effects and interactions, events more liable to occur in these patients as a result of both pharmacokinetic and pharmacodynamic factors. Occasionally serious interactions may occur with drugs used during anaesthesia. The importance of adequate pre-operative assessment and preparation cannot be overemphasized, as well as the need for a team approach to the management.