Spinal Anesthesia
Conditions
Keywords
unilateral epidural anesthesia, combined lumbar and epidural anesthesia
Brief summary
Because of population ageing, fragility fractures have become a huge burden on healthcare systems and wider society. Fractures result in a sharp drop in both short-term and long-term quality of life, they have a strong influence on activities of daily living and mobility, and they are associated with a significant increase in 1-year mortality (18%-36%). Surgery can benefit elderly patients with hip fractures to an extent, but it entails inevitable risks, particularly with respect to general anesthesia. In recent years unilateral spinal anesthesia has attracted attention due to the advantages of hemodynamic stability, reduced anesthetic dosage, and sufficient sensory block. On the basis of a previous study, in the current study anesthetics were directly implanted into the unilateral epidural space in elderly patients with hip fractures prior to the completion of surgery. Data from 106 patients with old hip fractures who had undergone surgical treatment incorporating unilateral epidural anesthesia (UEA) or combined lumbar and epidural anesthesia were retrospectively analyzed in an attempt to provide a feasible solution for this kind of patients' anesthesia.
Detailed description
Surgery can benefit elderly patients with hip fractures to an extent, but it entails inevitable risks, particularly with respect to general anesthesia. In recent years unilateral spinal anesthesia has attracted attention due to the advantages of hemodynamic stability, reduced anesthetic dosage, and sufficient sensory block. On the basis of a previous study, in the current study anesthetics were directly implanted into the unilateral epidural space in elderly patients with hip fractures prior to the completion of surgery.
Interventions
PROCEDUREunilateral epidural anesthesia
The patients received unilateral epidural anesthesia
PROCEDUREcombined lumbar and epidural anesthesia
The patients received combined lumbar and epidural anesthesia
Sponsors
Sichuan Provincial People's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
66 Years to 94 Years
Healthy volunteers
No
Inclusion criteria
had a fracture of a proximal femur were aged \> 65 years the fracture occurred within 2 weeks of receiving treatment with comorbidities including pulmonary disease, arrhythmia, senile valve disease or lacunar infarction underwent intraspinal anesthesia during surgery
Exclusion criteria
had a secondary fracture after endoprosthetic reconstruction or intramedullary nail had a pathological fracture caused by tumor or tuberculosis condition was accompanied by lower limb nerve dysfunction had a cognitive or psychiatric disorder coagulation disorders hospitalization data were incomplete.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hemodynamic change | Within 5 minutes after anesthesia | Heart rate |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Dose of ephedrine use | During the surgery period | Recoded dose of ephedrine use |
Other
| Measure | Time frame | Description |
|---|---|---|
| Lower limb function | One year later | Lower limb function (Harris score) |
| Duration of hospital stay | During the surgery period | Recoded duration of hospital stay |
| Mortality | Perioperative period | Mortality |
Countries
China
Outcome results
None listed