Surgical risk depends on the patient's overall state of health, not on chronologic age. On the operating table, a bolster can be placed under the knees to relieve stretch on back muscles. Foam padding, available in most operating rooms, can be placed between specific pressure points and the operating table to prevent direct contact, which can lead to pressure sores. Extremities are positioned carefully to avoid injury. Patients with spinal curvature or limited motion need padding placed in a manner that distributes pressure over as large an area as possible, avoiding small pressure points.
Arthritic changes can make positioning and intubation difficult.
Monitoring Intraoperative monitoring of blood pressure, heart rate and rhythm, ventilation, fluid status, and urinary output is similar in patients of all ages. For frail patients with fragile skin, the blood pressure cuff should be applied with care, using a thin layer of cotton undercast padding to protect the skin if needed. Oxygen saturation is monitored with a pulse oximeter, typically placed on the finger. However, the signal quality at this site may be inadequate because of decreased pulsatile flow in the elderly. If quality is inadequate, the probe can be placed on the earlobe.