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The Elderly Spine Surgery Patient: Pre- and Intraoperative Management of Drug Therapy

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Abstract

Spine surgery is one of the most common surgeries for adults greater than 65 years of age. Optimizing and caring for the elderly patient presenting for spine surgery requires planning and multidisciplinary input from surgeons, primary care physicians, and anesthesiologists. Controversies exist surrounding appropriate perioperative management of complicated chronic medication regimens and the ideal selection of intraoperative therapy for these patients. In this article we present an overview of the controversies anesthesiologists face as they work with the elderly patient’s primary doctor and surgical team to achieve a safe perioperative course. Specifically, we discuss the interaction of geriatric physiology and pathophysiology with medications used in the perioperative period. While care of the geriatric spine surgery patient is nuanced, the anesthesiologist can work together with medical personnel, surgeons, and pharmacy to provide safe and effective care.

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Acknowledgments

Dr. Deiner would like to acknowledge previous support by the Alzheimer’s Disease Research Center, Foundation for Anesthesia Education and Research, and the American Geriatrics Society.

Conflict of interest

Dr. Brallier has no conflicts of interest. Dr. Deiner currently receives support from the National Institute of Aging (R01-13-0359-01001-01-PD) and has received product support from Covidien Ltd and CAS Medical Systems, Inc.

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Authors and Affiliations

  1. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box #1010, New York, NY, 10029-6574, USA

    Jess W. Brallier & Stacie Deiner

  2. Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Stacie Deiner

  3. Department of Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Stacie Deiner

Authors
  1. Jess W. Brallier
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  2. Stacie Deiner
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Correspondence to Jess W. Brallier.

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Brallier, J.W., Deiner, S. The Elderly Spine Surgery Patient: Pre- and Intraoperative Management of Drug Therapy. Drugs Aging 32, 601–609 (2015). https://doi.org/10.1007/s40266-015-0278-5

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