Thoracic Anesthesia for the Geriatric Patient

As the population ages, the number of patients of advanced age who present for thoracic surgery will steadily increase. Optimal management of these patients in the perioperative period will necessitate an understanding of changes in physiologic reserve and consideration of comorbid conditions and overall health status. Chronic obstructive pulmonary disease and congestive heart failure in particular have implications for postoperative morbidity and mortality. Patient quality of life, overall life expectancy, and functional status must also be considered. Various studies involving preoperative assessment aim to elucidate risk factors and implement resources to optimize overall patient health and physiologic condition and thus decrease morbidity and mortality. Minimally invasive surgical techniques, extent of surgical resection, and anesthetic considerations may all play roles in achieving satisfactory outcomes in this population.