Hip Fracture
Conditions
Brief summary
Despite many previous studies, whether anesthetic technique will significantly affect overall patient outcome, morbidity and mortality in elderly hip fracture patients is controversial. Due to old age, poor patient condition and emergent clinical settings, patients undergoing surgical procedures for hip fracture management are often subject to poor postoperative outcome and high mortality rates. While many studies have reported that regional anesthesia leads to improved postoperative outcome after hip fracture surgery, others have concluded otherwise. Moreover, because the majority of these previous studies are retrospective cohorts or systemic reviews, there is a need for randomized clinical trials to provide high quality evidence. This study aims to compare patient outcome between three different anesthetic techniques in elderly patients undergoing surgery for hip fracture management by evaluating proinflammatory cytokines, chemistry lab testing and clinical outcome between general anesthesia with either desflurane or propofol-based TIVA and spinal anesthesia with bupivacaine.
Interventions
DRUGDesflurane
Inhalation anesthesia with desflurane at age-adjusted MAC of 0.8\ 1.0
DRUGPropofol
Total intravenous anesthesia with propofol target controlled infusion
DRUGBupivacaine
Spinal anesthesia with 0.5% bupivacaine
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1\. Patients older than 65 years scheduled for elective or emergency hip fracture surgery.
Exclusion criteria
1. Patient refusal 2. Inflammation or wound at puncture site, increased intracranial pressure, bleeding diathesis 3. Allergies to propofol or its ingredients, soybeans or peanuts 4. Patients with altered mental status 5. Illiterate patients or foreigners
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| HMGB1 | from preoperative baseline to 72hours |
| IL-6 | from preoperative baseline to 72hours |
| NT-proBNP | from preoperative baseline to 72hours |
| hemoglobin | from preoperative baseline to 72hours |
| total lymphocyte count | from preoperative baseline to 72hours |
| albumin | from preoperative baseline to 72hours |
| creatinine | from preoperative baseline to 72hours |
| potassium | from preoperative baseline to 72hours |
| troponin-T | from preoperative baseline to 72hours |
| CRP | from preoperative baseline to 72hours |
Countries
South Korea
Outcome results
None listed