An aging population brings a rise in surgical interventions for older adults, many of whom present with multiple comorbidities and altered pharmacodynamics. Geriatric anesthesia: challenges and solutions addresses the delicate balance required to maintain hemodynamic stability, cognitive function, and organ protection. Polypharmacy, frailty, and impaired physiological reserves complicate anesthetic planning and necessitate comprehensive preoperative assessments. Tailored anesthesia plans that minimize delirium, preserve baseline function, and encourage early mobility are critical. Techniques such as regional anesthesia, BIS monitoring, and opioid-sparing regimens are proving valuable in reducing postoperative complications. Enhanced Recovery protocols adapted for elderly patients are gaining traction, offering structured pathways for safer surgical journeys. As life expectancy rises, geriatric anesthesiology is evolving into a nuanced subspecialty that blends science with empathy and age-aware clinical judgment.
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