The older orthopaedic patient

General considerations

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

People older than 65 years are more likely to need elective and emergent orthopaedic surgery compared with younger persons. They also experience significant benefits. Although age-related changes increase the risk of perioperative complications, understanding those changes allows prevention or at least early recognition and treatment when problems arise. Because of comorbidities, older persons take more medications that need to be managed in the perioperative period. Care could be simplified if patients were to bring their medications to the preoperative evaluation. Central nervous system sensitivity to certain pain medications (meperidine and propoxyphene) means that these drugs are best avoided as good alternatives exist (morphine and oxycodone). Adverse reactions to drugs are an important cause of acute confusion (delirium) that often complicates orthopaedic care. Early mobilization after surgery, avoiding certain drugs, avoiding restraints (including Foley catheters), attending to hydration, promoting normal sleep, compensating for sensory disorders, and stimulating daytime activities can prevent delirium. Patients with dementia are more likely to have delirium develop and, like many older people, will present special challenges in communication and decision making. Including family members in discussions may be helpful in ensuring truly informed consent.

Original languageEnglish (US)
Pages (from-to)44-49
Number of pages6
JournalClinical Orthopaedics and Related Research
Issue number425
StatePublished - Jan 1 2004

Fingerprint

Delirium
Orthopedics
Sensation Disorders
Dextropropoxyphene
Oxycodone
Confusion
Early Ambulation
Meperidine
Perioperative Period
Drug-Related Side Effects and Adverse Reactions
Informed Consent
Pharmaceutical Preparations
Morphine
Dementia
Comorbidity
Decision Making
Sleep
Catheters
Central Nervous System
Communication

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

The older orthopaedic patient : General considerations. / Potter, Jane Frances.

In: Clinical Orthopaedics and Related Research, No. 425, 01.01.2004, p. 44-49.

Research output: Contribution to journalArticle

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