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Management of the anesthesic process of the geriatric patient in the surgical procedure

Author: Şandru Serghei
Degree:doctor habilitat of medicine
Speciality: 14.00.37 - Anaesthesiology and Reanimathology
Scientific consultants: Gheorghe Ghidirim
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Victor Cojocaru
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova


The thesis was presented on the 18 January, 2019
Approved by NCAA on the 15 March, 2019


Adobe PDF document1.56 Mb / in romanian


CZU 617-089.5-053.9(043.2)

Adobe PDF document 8.51 Mb / in romanian
271 pages


elderly patient, perianesthesic management, anesthesia, anesthesic risk


Thesis structure: The thesis is exposed on 268 pages and consists of introduction, 5 chapters, general conclusions and recommendations, abstracts in Romanian, Russian, English, and bibliography with 357 references. Illustrative material includes 76 tables, 99 figures and 18 annexes. The obtained results are reflected in 50 scientific papers, including - a monograph, a patent for invention.

Goal and objectives of the paper: Evaluation of the anesthesic process of the geriatric patient during surgical procedure with optimization of management in this category of patients. Novelty and scientific originality: We’ve identified the methods and tools of medical-biological research and the technological ones for preoperative preparation and reduction of ASA risk through the multilateral examination and the proposed anesthesiological assistance, which allowed to offer solutions for the efficiency and safety of the perioperative care of the elderly patient.

Resolved scientific issue: The results of the studies have been developed a methodology for multilateral assessment of respiratory function, cardiac function, central haemodynamics, central nervous system function, to highlight their disorders in a geriatric patient, in view to improve anesthesia and perioperative care in the surgical treatment. Various methods of anesthesia and intensive care have been researched for choosing the most optimal anesthetic methods during surgery, post-anesthetic and postoperative period. Various corrective methods have been studied in preparation of geriatric patient for surgery, including postoperative cognitive dysfunction prophylaxis. During the work, a patented method was developed and implemented in the clinic: continuous spinal anesthesia in the elderly patient in lateral position and using the local hypobaric anesthetic solution.

Theoretical significance: It has been demonstrated that continuous spinal anesthesia with hypobaric local anesthetic proposed by us is a priority for the elderly patient and is accompanied by the hemodynamic stability, of heart rate and perioperative medical-biological state of the elderly patient with the possibility of adequate postoperative analgesia. Our study demonstrated the efficacy of administration of proposed brain antioxidants in prophilaxis of postoperative cognitive disorders.

Applicative value: The practical application of the formulated recommendations allows to reduce the rate of complications in the elderly patient in the surgical treatment along with significant reduction of the perioperative incidents.

The results of the study were implemented in the Clinic of Anesthesiology and Reanimatology of Institute of Emergency Medicine, as well as in the didactic activity of the Chair of Anesthesiology-Reanimatology No. 1 "Valeriu Ghereg" of S.U.M.Ph. "Nicolae Testemitanu".