Anaesthesia for hip fracture surgery in adults

Parker, Martyn J.; Handoll, Helen; Griffiths, R.

doi:10.1002/14651858.cd000521.pub2

Cited by 212 publications

(166 citation statements)

References 45 publications

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“…Postoperative complications contribute significantly to the risks of surgery and anaesthesia, with impact on discharge and financial repercussions on the health system [19]. The risk of perioperative complications depends on ASA (American Society of Anesthesiologists) class [20], age [21], emergency surgery, cardiac comorbidities [22], smoking [23], duration of surgery [24], type of anaesthesia [25], as well as on the presence of comorbidities such as chronic obstructive pulmonary disease, coronary artery disease, and renal failure [26]. In our study, the most frequent encountered complications were respiratory and cardiovascular, and these were present in all [+] patients presented higher incidences of postoperative complications compared to OSA [-] patients, similarly to previously published data.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Tatiana

Șandru

Belîi

2016

Rom J Anaesth Int Care

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Section: Discussionmentioning

confidence: 99%

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Tatiana

Șandru

Belîi

2016

Rom J Anaesth Int Care

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“…[16] Parker et al . [17] investigated in a Cochrane meta-analysis 22 clinical trials involving 2567 patients where neuraxial (mainly spinal) anesthesia was compared with general anesthesia. Despite the fact that all included trials had methodical problems, the authors found a reduced risk for postoperative deep venous thrombosis (30% compared with 47%) and acute postoperative confusion (9.4% compared with 19.2%) in patients treated with neuraxial (mainly spinal) anesthesia compared with general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery

Ellakany

2014

Anesth Essays Res

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Aim:A double-blinded randomized controlled study to compare discharge time and patient satisfaction between two groups of patients submitted to open surgeries for abdominal malignancies using segmental thoracic spinal or general anesthesia.Background:Open surgeries for abdominal malignancy are usually done under general anesthesia, but many patients with major medical problems sometimes can’t tolerate such anesthesia. Regional anesthesia namely segmental thoracic spinal anesthesia may be beneficial in such patients.Materials and Methods:A total of 60 patients classified according to American Society of Anesthesiology (ASA) as class II or III undergoing surgeries for abdominal malignancy, like colonic or gastric carcinoma, divided into two groups, 30 patients each. Group G, received general anesthesia, Group S received a segmental (T9-T10 injection) thoracic spinal anesthesia with intrathecal injection of 2 ml of hyperbaric bupivacaine 0.5% (10 mg) and 20 ug fentanyl citrate. Intraoperative monitoring, postoperative pain, complications, recovery time, and patient satisfaction at follow-up were compared between the two groups.Results:Spinal anesthesia was performed easily in all 30 patients, although two patients complained of paraesthesiae, which responded to slight needle withdrawal. No patient required conversion to general anesthesia, six patients required midazolam for anxiety and six patients required phenylephrine and atropine for hypotension and bradycardia, recovery was uneventful and without sequelae. The two groups were comparable with respect to gender, age, weight, height, body mass index, ASA classification, preoperative oxygen saturation and preoperative respiratory rate and operative time.Conclusion:This preliminary study has shown that segmental thoracic spinal anesthesia can be used successfully and effectively for open surgeries for abdominal malignancies by experienced anesthetists. It showed shorter postanesthesia care unit stay, better postoperative pain relief and patient satisfaction than general anesthesia.

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“…Despite some conflicting reports, a growing number of studies indicate that neuraxial anesthesia may prove beneficial to patients undergoing major joint replacement [8][9][10][11][12][13] . However, and as mentioned previously, neuraxial anesthetic techniques remain widely underutilized on a national level.…”

Section: Benefits and Pitfallsmentioning

confidence: 99%

Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review

Opperer

Danninger

Stundner

et al. 2014

WJO

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Over the last decades the demand for hip surgery, be it elective or in a traumatic setting, has greatly increased and is projected to expand even further. Concurrent with demographic changes the affected population is burdened by an increase in average comorbidity and serious complications. It has been suggested that the choice of anesthesia not only affects the surgery setting but also the perioperative outcome as a whole. Therefore different approaches and anesthetic techniques have been developed to offer individual anesthetic and analgesic care to hip surgery patients. Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome, showing favorable results in the usage of regional vs general anesthesia. In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome. While there still remains a scarcity of data investigating perioperative outcomes and anesthesia, most studies concur on a positive outcome in overall mortality, thromboembolic events, blood loss and transfusion requirements when comparing regional to general anesthesia. Much of the currently available evidence suggests that a comprehensive medical approach with emphasis on regional anesthesia can prove beneficial to patients and the health care system.

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Anaesthesia for hip fracture surgery in adults

Cited by 212 publications

References 45 publications

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

The prevalence of perioperative complications in patients with and without obstructive sleep apnoea: a prospective cohort study

Thoracic spinal anesthesia is safe for patients undergoing abdominal cancer surgery

Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review

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