**17. Other considerations**

Generally, postoperative nausea and vomiting (PONV) and pain are the two most common causes for unpredicted admission after scheduled outpatient surgery. Risk factors for PONV are female gender, previous PONV or motion sickness, nonsmoking status, and opioid use. In addition, geriatric patients experience an increased incidence of conduction abnormalities and bradyarrhythmias including atrial arrhythmias and atrial fibrillation. Transient, subclinical hearing loss is not uncommon after spinal anesthesia [33]. The pathophysiology is supposed to encompass movement of perilymph from the ear into the subarachnoid space as cerebrospinal fluid leaks out. The prevalence rate of mild hearing loss after spinal anesthesia differs inversely with the patient's age. Moreover, geriatric patients are at higher risk for drowsiness, confusion, urinary retention, and adverse drug interactions than the younger patiens. For geriatric outpatients, an escort should stay with the patient for at least 24 hours postoperatively.

## **18. Conclusion**

Geriatric patients are exclusively vulnerable and particularly sensitive to the stresses of hospitalization, anesthesia and surgical procedure. However, age alone does not serve as deterrent for surgical procedures. The care of geriatric patients can be complex and will be a growing task. A balance between physiological and psychological alterations is required in these patients. No anesthetic agent or technique is clearly superior for all conditions or settings. Suitable preoperative, intraoperative and postoperative management is needed of geriatric patients. Additionally, anesthesiologists must have a knowledge of the physiological, pharmocokinetic and pharmacodynamic differences before they utilize their anesthetic techniques.

#### **Conflict of interest**

I have no conflict of interest.

## **Author details**

Somchai Amornyotin Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

\*Address all correspondence to: somchai.amo@mahidol.ac.th

© 2021 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

*Anesthetic Consideration for Geriatric Patients DOI: http://dx.doi.org/10.5772/intechopen.97003*
