Is anesthesia safe for a 79-year-old diabetic male?

Question

Hi doctor,

I am advised to have a gastric bypass. I am worried about the anesthesia, and surgical risk.

I am a 79-year-old married male. I am obese weighing 265 pounds, and 5 feet 11 inches tall. I am a diabetic, but it is under control with insulin. I also have emphysema. I use Spiriva daily and wear a prescribed sleep apnea machine at night. I left the habit of smoking when I was 40.

I am on regular medicine for high blood pressure. Presently, I have achalasia, and I am considering laparoscopic surgery for it. Also, I am on regular Prednisone 5 mg for arthritis and Allegra for ongoing congestion.

Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Regarding your query, you are definitely having a high risk of postoperative complications after surgery. You cannot eliminate your comorbidities, but can only optimize them.

Do not stop any medication on your own, as it may cause unnecessary delay in the procedure. Please talk to your anesthetist first, so that he can evaluate the overall status of your health. There are chances that you may require ventilator support in the immediate postoperative period, but do not worry about that. Everything will be fine.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Yes, I must say that there are too many risks involved. Obesity and respiratory illness increase the risk severalfold, especially with laparoscopic surgeries. It would help if you asked for other feasible options available.

Your perception of the anesthesia technique is not adequate. Anesthesia with the mask is only for very short procedures. In most of the surgeries, we start with intravenous drugs. Once the patient is asleep, we intubate the patient and deliver inhalational anesthetic agents through an endotracheal tube. Laparoscopic surgery is a specialized technique of surgery, and there is no difference in technique of providing anesthesia in laparoscopic or open surgeries. So I advise you to meet your anesthetist personally because he is the one who can actually evaluate your current health status.

One thing I want to add is that we are not only treating the illness but the overall improvement and quality of life should be our goal.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.