Chapter 3 DISCUSSION

The aim of the present investigation was to study and evaluate the shortterm biological and clinical reactions to a few different types of anaesthesia and an extensive operative procedure in elderly patients. Ideally, a homogeneous group of patients should be chosen for thii purpose, and each type of anaesthesia as well as the operative and other therapeutic procedures should be as consistent and stereotyped as possible. Male patients treated by prostatectomy were chosen according to certain criteria, but it was unavoidable that certain biological factors of a predisposing character were inconsistent in the group of patients, e.g. the level of respiratory and circulatory functional capacities. The influence of such factors must therefore be considered separately. Also, certain therapeutic factors varied in different patients, e. g. blood loss and blood replacement or duration of operation, and must be considered separately. The question may be asked whether the findings at the preoperative examinations were truly representative of the daily condition and function of the patients, as elderly patients are known to react sometimes to hospitalization with a state of stress, they become more anxious than usual and even show psychotic symptoms (KNOX, 1961)'s. This must be considered, especially when the operation is believed by the patients to be severe and hazardous, as in the present case. The clinical impression was that a few of the patients investigated were nervous and tense but not considerably so, and there were no psychotic symptoms.