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In geriatric patients, the resolution of spinal anesthesia may be prolonged primarily due to delayed drug elimination. As individuals age, various physiological changes occur, including alterations in liver and kidney function, which can significantly affect the pharmacokinetics of anesthetic agents. The metabolic rate declines, leading to a slower clearance of drugs from the body. This slower elimination means that anesthetics remain in the system longer, prolonging the effects of spinal anesthesia.

While changes in body composition, such as an altered lean-to-fat ratio, and impaired nerve transmission can impact how the body processes anesthetics, they do not primarily account for the delayed resolution in the context of spinal anesthesia. Additionally, the notion that more anesthetic is required does not typically correlate with prolonged resolution; rather, it may lead to stronger or longer-lasting effects initially, but not necessarily in the context of drug elimination. Understanding this pharmacological aspect is crucial in managing geriatric patients effectively and anticipating their recovery time post-anesthesia.