Sevoflurane in elderly patients

An ideal anaesthetic should allow rapid, pleasant, and predictable inductio n, maintenance and emergence from anaesthesia. Little information is availa ble about sevoflurane use in elderly patients. The pharmacological profile of sevoflurane may be advantageous in geriatric patients because low solubi lity in the blood is a prerequisite for rapid changes in anaesthetic depth. In addition, the pharmacological profile of sevoflurane may help to reduce the total amount of drug required. Using volatile anaesthetics with low bl ood solubility and rapid clearance may help in an early postoperative asses sment of the neurological status. Because geriatric patients show a higher intraoperative variability of haemodynamic parameters when compared to youn ger patients a drug such as sevoflurane with ra pid uptake and elimination may be advantageous for treatment of hyper- and hypotensive states. As a co nsequence, the need for vasoactive drugs may be reduced. Recovery from sevo flurane anaesthesia is faster when compared with isoflurane. However,there is still controversy if the occurrence of postoperative cognitive and menta l impairment is reduced in elderly patients if drugs with fast elimination characteristics are use. Few data are available on the use of sevoflurane i n geriatric patients with renal impairment. Further studies are needed to c larify if the administration of sevoflurane is safe in this population of p atients.