Geriatric surgery: Personalized care, better outcomes

Fatima Khan

doi:10.35841/aaacsr-9.3.224

Mini Review - Anesthesiology and Clinical Science Research (2025) Volume 9, Issue 3

Geriatric surgery: Personalized care, better outcomes

Maria Costa^*

Department of Obstetric Anesthesia, University of Lisbon, Lisbon, Portugal

*Corresponding Author:: Maria Costa
Department of Obstetric Anesthesia
University of Lisbon, Lisbon, Portugal.
E-mail: maria.costa@ulisboa.pt

Received : 02-Sep-2025, Manuscript No. aaacsr-224; Editor assigned : 04-Sep-2025, PreQC No. aaacsr-224(PQ); Reviewed : 24-Sep-2025, QC No aaacsr-224; Revised : 03-Oct-2025, Manuscript No. aaacsr-224(R); Published : 14-Oct-2025 , DOI : 10.35841/aaacsr-9.3.224

Citation: Costa M. Obstetric anesthesia: Evolving challenges, advanced care. aaacsr. 2025;09(03):224.

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Introduction

Obstetric anesthesia adapted to the post-pandemic landscape, emphasizing significant challenges like staffing shortages and burnout, alongside innovations such as expanded telemedicine and enhanced infection control protocols. It shows how these shifts prompted a re-evaluation of resource allocation and service delivery models, pushing for more flexible and resilient care strategies to ensure patient safety and optimize outcomes in a rapidly changing healthcare environment[1].

The relationship between neuraxial anesthesia and the risk of postpartum hemorrhage has been explored, concluding that while neuraxial techniques are generally safe, specific considerations are crucial to minimize this risk. The findings suggest that appropriate fluid management, timely recognition of uterine atony, and vigilance for coagulopathy remain paramount, reinforcing the need for careful patient selection and monitoring to prevent adverse outcomes[2].

Essential guidance for managing anesthesia in parturients with pre-existing cardiac disease is provided, detailing individualized approaches based on the specific condition. It emphasizes meticulous hemodynamic monitoring, collaboration with cardiologists, and careful selection of anesthetic techniques to optimize maternal and fetal outcomes while mitigating the inherent risks associated with cardiac comorbidities during pregnancy and delivery[3].

Significant benefits of Enhanced Recovery After Cesarean Section (ERACS) protocols have been demonstrated, including reduced hospital stay, lower postoperative pain scores, and decreased opioid consumption. The findings underscore ERACS as a highly effective strategy for improving maternal recovery and patient satisfaction, advocating for its widespread implementation in obstetric practice to optimize surgical outcomes[4].

The anesthetic management of preeclampsia and eclampsia has been explored, highlighting the critical role of neuraxial anesthesia for pain management and blood pressure control. The review emphasizes careful assessment of coagulation status and vigilant hemodynamic monitoring to prevent maternal complications, advocating for a multidisciplinary approach to ensure the safest care for these high-risk parturients[5].

The unique challenges posed by twin and higher-order multiple pregnancies in obstetric anesthesia are discussed, including increased risks for preterm labor, preeclampsia, and postpartum hemorrhage. It details tailored anesthetic strategies for both vaginal and cesarean deliveries, underscoring the importance of meticulous preparation and skilled management to address the complex physiological and anatomical changes specific to these gestations[6].

Opioid-sparing anesthesia techniques in obstetric patients have been examined, highlighting multimodal approaches that integrate regional anesthesia, NSAIDs, and other non-opioid analgesics. The findings demonstrate improved pain control, reduced opioid-related side effects, and enhanced maternal recovery, promoting strategies that minimize opioid exposure while effectively managing peripartum pain[7].

Anesthetic considerations for parturients with peripartum cardiomyopathy are focused upon, emphasizing the need for meticulous hemodynamic management to optimize cardiac function during labor and delivery. It outlines strategies for careful fluid balance, appropriate vasopressor use, and individualized anesthetic plans to prevent decompensation in these vulnerable patients[8].

The complexities of providing anesthesia for obese parturients are addressed, detailing challenges related to airway management, neuraxial techniques, and pharmacological considerations. It highlights strategies such as careful positioning, specialized equipment, and appropriate dosing adjustments to ensure safe and effective anesthetic care, aiming to mitigate increased risks of complications in this patient population[9].

A comprehensive overview of anesthetic and critical care management for severely ill obstetric patients is provided, emphasizing a multidisciplinary approach to address various organ system dysfunctions. It underscores the importance of prompt diagnosis, aggressive resuscitation, and continuous monitoring to optimize maternal and fetal outcomes in the context of critical illness[10].

Conclusion

Obstetric anesthesia continuously adapts to evolving challenges, from post-pandemic landscape shifts to specific high-risk conditions. Recent advancements highlight the importance of resilient care strategies, integrating expanded telemedicine and stringent infection control measures, alongside addressing staffing shortages and burnout. The field emphasizes careful patient selection and monitoring, particularly concerning neuraxial anesthesia's role in mitigating postpartum hemorrhage risks through appropriate fluid management and vigilance for coagulopathy. Specialized approaches are crucial for parturients with pre-existing cardiac disease, necessitating individualized plans, meticulous hemodynamic monitoring, and interdisciplinary collaboration. Protocols like Enhanced Recovery After Cesarean Section (ERACS) have proven effective in improving maternal recovery by reducing hospital stays, pain, and opioid consumption. Furthermore, anesthetic management for conditions like preeclampsia, eclampsia, and peripartum cardiomyopathy underscores the need for vigilant hemodynamic control and coagulation assessment. Anesthesia for complex cases such as twin and higher-order multiple pregnancies or obese parturients requires tailored strategies, specialized equipment, and careful dosing adjustments. A significant trend involves implementing opioid-sparing anesthesia techniques, combining regional blocks and non-opioid analgesics to optimize pain control and reduce side effects. Overall, the comprehensive management of severely ill obstetric patients consistently advocates for a multidisciplinary approach, focusing on prompt diagnosis, aggressive resuscitation, and continuous monitoring to ensure optimal maternal and fetal outcomes.