Perioperative Care of the Elderly

Gabriella Bettelli specializes in Anesthesia and Intensive Care and Cardiology, with a 2nd-Level University Master in Geriatrics and qualification as an Internal Quality Auditor. After dealing with anesthesia in vascular, outpatient (SIOH Prize 1993), ENT and obstetric anesthesia, she was Medical Director of the Geriatric Surgical Area and Head of the Anesthesia Department at the Italian National Research Centers of Aging, Ancona (INCRA), between 2008 and 2011. Professor Bettelli developed the first clinical path for geriatric surgery in Italy, is a fellow of numerous scientific societies, and founded the Italian National Anesthesia Society (SIAARTI) Study Group 'Perioperative Geriatric Medicine.' She is currently Educational Coordinator of the 2nd-Level Master in Perioperative Geriatric Medicine at the University of San Marino.

Foreword; Preface; Introduction: population aging, healthcare systems and surgery; Part I. Preoperative Evaluation: 1. Aging and age-related functional changes; 2. Preoperative evalution: a 360° perspective; 3. Comorbidities and multimorbidity; 4. Poly-medication and perioperative drugs management; 5. Assessment of functional reserves; 6. Cognitive and emotional evaluation; 7. Sensorial evaluation and impact of hearing and visual impairment on communication; 8. Preoperative testing; 9. Team-based discussion on preoperative evaluation and decision-making about surgery; 10. Communication and informed consent; 11. Preoperative care in emergency surgery; Part II. Preparation to Surgery: 12. Prehabilitation: how to enhance cardio-respiratory functional reserves before surgery; 13. Diagnosis and treatment of nutritional deficits; 14. Prevention of cognitive complications; 15. Psychological support in elderly surgical patients; 16. The role of geriatric nurses in preparing the elderly for surgery; Part III. Intraoperative Management: 17. Entering the operating theatre: a challenging experience; 18. Safety in the operating room: special needs of geriatric patients; 19. The geriatric patient and anesthesia; 20. Regional anesthesia techniques; 21. Fluids and electrolytes management; 22. Surgery in the elderly: general considerations; 23. Cancer surgery and the elderly; 24. Orthopedic surgery; 25. Cardiovascular surgery; 26. Thoracic surgery; 27. Abdominal surgery; 28. Day surgery; 29. Cataract surgery and other office-based procedures; Part IV: Postoperative Management: 30. The elderly in the recovery room; 31. Endocrine and metabolic response to surgical stress in the elderly; 32. Postoperative pain treatment; 33. General principles of postoperative recovery; 34. Fast-track and ERAS programs in geriatric surgery; 35. Postoperative nursing; 36. Cardiovascular complications; 37. Perioperative venous thromboembolism in the elderly: prevention and treatment; 38. Treatment of postoperative delirium; 39. Postoperative respiratory complications; 40. Renal complications; 41. Postoperative admission to the intensive care unit; 42. Prevention of postoperative geriatric syndromes; 43. Planning for discharge; 44. Ethics in geriatric surgery, end of life and palliative care; Part V. Key Issues for Optimal Organization: 45. Models of care and organizational solutions for geriatric surgery; 46. Hospital design; 47. Patient's safety, ergonomics and clinical risk management; 48. Systemic approach to management in GS: methods and tools; 49. Systems engineering in GS: the contribute of modelling and simulation; 50. Closing the loop with the client's perspective: how the elderly live the experience of surgery; Index.