Does regional anesthesia increase the risk of falling in elderly patients?

2021 ◽  
Vol 90 ◽  
pp. 306-307
Author(s):  
J. Weichmann ◽  
A. Hogan ◽  
S. Hetjens ◽  
L.C. Siegwart ◽  
P.A. Grützner ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Regional Anesthesia ◽  
Risk Of Falling

scholarly journals Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski
Keyword(s):  
Drug Therapy ◽  
Adverse Effects ◽  
Elderly Patients ◽  
Regional Anesthesia ◽  
Pain Control ◽  
The Elderly ◽  
Surgical Patient ◽  
Cochrane Central Register ◽  
Promising Alternative ◽  
Age Related

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.

scholarly journals Rethinking the neurological examination I: static balance assessment

2011 ◽  
Vol 69 (6) ◽  
pp. 954-958 ◽  
Author(s):  
Péricles A. Maranhão-Filho ◽  
Eliana Teixeira Maranhão ◽  
Marcos Martins da Silva ◽  
Marco Antônio Lima
Keyword(s):  
Elderly Patients ◽  
Neurological Examination ◽  
Sensory Integration ◽  
Static Equilibrium ◽  
Static Balance ◽  
Clinical Test ◽  
Balance Assessment ◽  
Risk Of Falling ◽  
Functional Reach ◽  
Functional Reach Test

The authors advocate a modernization of the neurologic exam with regard to the evaluation of static equilibrium through the application of some easily performed and interpreted bedside maneuvers like the Clinical Test of Sensory Integration and Balance - modified and the Functional Reach Test. The authors also believe that these and other assessments, such as that of the risk of falling for elderly patients, should be incorporated into the routine neurological examination.

scholarly journals Observation on the risk of falling and self-efficacy in elderly patients with hip fracture

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Zongyou Mou ◽  
Ke Song ◽  
Jinquan Guo
Keyword(s):  
High School ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Self Efficacy ◽  
School Education ◽  
High School Education ◽  
Risk Of Falling ◽  
Post Surgery ◽  
Number Of Patients

Objectives:To study the risk of falling and self-efficacy in elderly patients with hip fracture. Methodology: Forty elderly patients with hip fractures that were caused by falling were admitted into our hospital from April 2018 to April 2019, and were enrolled into this study. All patients were assessed by using the Morse Fall Scale (MFS) and Falls Efficacy Scale(FES).The basic situation of the patients with hip fractures caused by falling and the scores of MFS and FES before and after falling were evaluated. Results: Results showed that the number of patients with femoral neck fractures accounted for 70% out of all patients, and the number of patients with intertrochanteric fractures accounted for the remaining30%of the patients. The number of patients with academic qualification below primary school is 16, the number of patients with middle high school education is 11 and the number of patients with high school education and above is 13. Slipping is the cause of hip fracture that accounted for the most in patients, followed by outing activities, whereas least patients with hip fractures was caused by falling in nursing home. There were 29 patients’ whoused crutches or walking aids and this number was more than that of those who required the devices. After the MFS and FES analyses, the results (scores of MFS and FES) showed that the risk before the fall was lower. In contrast, the risk of fracture and post-surgery after the fall was greatly increased. Conclusion: The elderly patients with hip fractures were found to have increased risk of falling and thus, these patients require good care.

scholarly journals Effectiveness of additional thoracic paravertebral block in improving anesthetic effects of regional anesthesia for proximal humeral fracture surgery in elderly patients: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
xiaofeng wang ◽  
Hui Zhang ◽  
Zhenwei Xie ◽  
Qingfu Zhang ◽  
Wei Jiang ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Brachial Plexus ◽  
Regional Anesthesia ◽  
Proximal Humeral Fracture ◽  
Humeral Fracture ◽  
Cervical Plexus ◽  
Thoracic Paravertebral Block ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
Fracture Surgery

Abstract Background: The innervation of shoulder-upper extremity area is complicated and unclear. Regional anesthesia with brachial plexus and cervical plexus block is probably inadequate for the proximal humeral surgery. Missing blockade of T1-T2 nerves may be the reason. We conduct this prospective randomized controlled trial (RCT) to explore whether additional T2 thoracic paravertebral block (TPVB) can improve the success rate of regional anesthesia for elderly patients in proximal humeral fracture surgery. Methods: The patients aged 65 or older, referred for anterior approach proximal humeral fracture surgery, will be enrolled. Each patient will be randomly assigned 1:1 to receive IC block (combined interscalene brachial plexus with superficial cervical plexus block) or ICTP block (combined thoracic paravertebral block with brachial plexus and superficial cervical plexus block). The primary outcome is the success rate of regional anesthesia without rescue analgesic methods. The secondary outcomes are as follows: sensory block at surgical area, proportion of patients who need rescue anesthesia (intravenous remifentanil or conversion to general anesthesia), cumulative doses of intraoperative vasoactive medications and adverse events. The total sample size is estimated to be 80 patients. Discussion: This RCT aims to confirm whether additional T2 TPVB can provide better anesthetic effects of regional anesthesia with brachial and cervical plexus block in elderly patients undergoing proximal humeral surgery.

scholarly journals Traumatic events involving elderly patients treated with anticoagulants for atrial fibrillation: the downside of stroke prevention

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Alessandro Riccardi ◽  
Pierangela Minuto ◽  
Maria Ghinatti ◽  
Grazia Guiddo ◽  
Alessandro Calvia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Elderly Patients ◽  
Emergency Room ◽  
Stroke Prevention ◽  
Oral Anticoagulant ◽  
Traumatic Event ◽  
Risk Of Falling ◽  
Very Elderly ◽  
Permanent Atrial Fibrillation

A group of oral anticoagulant-treated patients affected by permanent atrial fibrillation was evaluated after their access to the emergency room as a result of a traumatic accident. In these patients, the re-evaluation of their risk of thromboembolism and bleeding was performed together with the evaluation of their risk of falling and institutionalization. Results show that the emergency department identifies a cohort of very elderly frail patients, who should be carefully reconsidered for anticoagulant therapy after a traumatic event.

Sign in / Sign up

Export Citation Format

Share Document