scholarly journals Comparison of Effects between Combined Lumbar-Sacral Plexus Block plus General Anesthesia and Unilateral Spinal Anesthesia in Elderly Patients Undergoing Hip Fracture Surgery: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lili Tang ◽  
Panpan Fang ◽  
Yuxin Fang ◽  
Yao Lu ◽  
Guanghong Xu ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Postoperative Delirium ◽  
Sacral Plexus ◽  
Hip Fracture Surgery ◽  
Unilateral Spinal Anesthesia ◽  
Plexus Block ◽  
Fracture Surgery

Purpose. Hip fracture is a common injury in geriatric populations, which is associated with poor quality of life. However, the ideal anesthesia technique for this disease is yet to be identified. This study aimed to compare the combined lumbar-sacral plexus block (CLSB) plus general anesthesia (bispectral index (BIS) 60–80) with the unilateral spinal anesthesia (SA) on activity of daily living in elderly patients undergoing hip fracture surgery. Methods. A total of 124 elderly patients undergoing hip fracture surgery were randomly assigned to two groups. Patients in the SA group received light-specific gravity spinal anesthesia, and patients in the CLSB group received lumbar and sacral plexus block with general anesthesia (BIS 60–80). The primary outcomes were 30-day activity of daily living (ADL). The secondary outcomes were postoperative pain scores, postoperative delirium, in-hospital cost, and major complications. Results. The ADL scores of postoperative day 30 (POD30) in the CLSB group are higher than those in the SA group (27.34 ± 7.01 versus 24.70 ± 6.40, P = 0.045 ). Compared to preoperative ADL scores, there were higher increased scores in the CLSB group than in POD30 (CLSB group 8.09 ± 3.39 versus SA group 4.87 ± 3.90, P < 0.001 ). Mild-to-moderate pain did not have differences between the two groups (rest pain: 3 versus 2, P = 0.344 ; motion pain: 5 versus 4, P = 0.073 ). There were no significant differences in incidence of postoperative delirium, PONV, and other complications. Conclusion. The unilateral SA can reduce the deterioration of ADL after hip fracture surgery and provide a better postoperative recovery.

scholarly journals Postoperative Delirium in Elderly Patients Undergoing Hip Fracture Surgery in the Sugammadex Era: A Retrospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Chung-Sik Oh ◽  
Ka Young Rhee ◽  
Tae-Gyoon Yoon ◽  
Nam-Sik Woo ◽  
Seung Wan Hong ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
General Anesthesia ◽  
Cholinesterase Inhibitor ◽  
Postoperative Delirium ◽  
Neuromuscular Block ◽  
Pulmonary Complications ◽  
Laboratory Findings ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Background.Residual neuromuscular block (NMB) after general anesthesia has been associated with pulmonary dysfunction and hypoxia, which are both associated with postoperative delirium (POD). We evaluated the effects of sugammadex on POD in elderly patients who underwent hip fracture surgery.Methods.Medical records of 174 consecutive patients who underwent hip fracture surgery with general anesthesia were reviewed retrospectively to compare the perioperative incidence of POD, pulmonary complications, time to extubation, incidence of hypoxia, and laboratory findings between patients treated with sugammadex and those treated with a conventional cholinesterase inhibitor.Results.The incidence of POD was not significantly different between the two groups (33.3% versus 36.5%, resp.;P=0.750). Postoperative pulmonary complications and laboratory findings did not showed significant intergroup difference. However, time to extubation (6 ± 3 versus 8 ± 3 min;P<0.001) and the frequency of postoperative hypoxia were significantly lower (23% versus 43%;P=0.010) in the sugammadex group than in the conventional cholinesterase inhibitor group.Conclusion.Sugammadex did not reduce POD or pulmonary complications compared to conventional cholinesterase inhibitors, despite reducing time to extubation and postoperative hypoxia in elderly patients who underwent hip fracture surgery under general anesthesia.

scholarly journals Comparison of combined lumbar and sacral plexus block with sedation versus general anaesthesia on postoperative outcomes in elderly patients undergoing hip fracture surgery (CLSB-HIPELD): study protocol for a prospective, multicentre, randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e022898 ◽  
Author(s):  
Junfeng Zhang ◽  
Xiaofeng Wang ◽  
Hui Zhang ◽  
Zhuolin Shu ◽  
Wei Jiang
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
General Anaesthesia ◽  
Postoperative Outcomes ◽  
Visual Analogue Scale Pain ◽  
Sacral Plexus ◽  
Hip Fracture Surgery ◽  
Randomised Controlled ◽  
Plexus Block ◽  
Fracture Surgery

IntroductionHip fracture in elderly people is a global public health problem, with substantial associated mortality and disability. Nearly all patients with hip fracture undergo surgical treatment, but optimal anaesthesia for hip fracture surgery in elderly patients is still inconclusive. Ultrasound-guided combined lumbar and sacral plexus block has been widely used in hip fracture surgery in recent years, especially for some high-risk patients. However, it is not clear whether it can improve the postoperative outcomes of elderly patients with hip fracture.Method and analysisThis research project is a two-arm, parallel, multicentre, prospective randomised controlled trail. A total of 1086 patients aged 75 and older scheduled for hip fracture surgery in five clinical trial centres of China will be randomised in a 1:1 ratio to receive either combined lumbar and sacral plexus block plus sedation or general anaesthesia. The primary outcome will be the postoperative 1-year all-cause mortality. The secondary outcomes will be the incidence of postoperative complications, high-sensitivity cardiac troponin T, early mobility after surgery, postoperative Visual Analogue Scale pain scores, postoperative delirium, length of stay in intensive care unit and hospital, cost-effective outcomes, Barthel Index and incidence of adverse events after discharge. Assessments will be conducted in four steps: preoperative, intraoperative, in-hospital data collection and post-discharge telephone follow-up.Ethics and disseminationThis study has been supported by Shanghai Municipal Commission of Health and Family Planning Foundation for Key Developing Disciplines (2015ZB0103) and approved by the Ethics Committee of Shanghai Sixth People’s Hospital [No: 2016–28-(2)]. At the time of manuscript submission, the protocol version is V.1.6 (March 2nd, 2018) with one subsequent approved amendment. Results will be disseminated via an international peer-reviewed publication.Trial registration numberNCT03318133.

The influence of anesthetic techniques on postoperative cognitive function in elderly patients undergoing hip fracture surgery: General vs spinal anesthesia

Injury ◽  
2018 ◽  
Vol 49 (12) ◽  
pp. 2221-2226 ◽  
Author(s):  
Petros Tzimas ◽  
Evangelia Samara ◽  
Anastasios Petrou ◽  
Anastasios Korompilias ◽  
Athanasios Chalkias ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Cognitive Function ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Anesthetic Techniques ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Haemodynamic effects of spinal anesthesia in elderly patients undergoing hip fracture surgery

2010 ◽  
Vol 27 ◽  
pp. 241-242
Author(s):  
A. Messina ◽  
L. Frassanito ◽  
A. Catalano ◽  
A. Castellana ◽  
S. Santoprete
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Haemodynamic Effects ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

scholarly journals Comparison of two doses of hypobaric bupivacaine in unilateral spinal anesthesia for hip fracture surgery: 5 mg versus 7.5 mg

2017 ◽  
Vol 28 ◽  
Author(s):  
Mohamed Kahloul ◽  
Mohamed Said Nakhli ◽  
Amine Chouchene ◽  
Nidhal Chebbi ◽  
Salah Mhamdi ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Spinal Anesthesia ◽  
Hip Fracture Surgery ◽  
Unilateral Spinal Anesthesia ◽  
Fracture Surgery

Impact of length of red blood cells transfusion on postoperative delirium in elderly patients undergoing hip fracture surgery: A cohort study

Injury ◽  
2016 ◽  
Vol 47 (2) ◽  
pp. 408-412 ◽  
Author(s):  
Zhuang-Yun Zhang ◽  
Da-Peng Gao ◽  
Jiao-jiao Yang ◽  
Xiao-ru Sun ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Postoperative Delirium ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

scholarly journals Effects of Anesthesia Techniques on Outcomes after Hip Fracture Surgery in Elderly Patients: A Prospective, Randomized, Controlled Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1605
Author(s):  
Seokyung Shin ◽  
Seung Hyun Kim ◽  
Kwan Kyu Park ◽  
Seon Ju Kim ◽  
Jae Chan Bae ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Troponin T ◽  
Controlled Trial ◽  
High Mobility ◽  
Secondary Outcome ◽  
Hip Fracture Surgery ◽  
Balanced Anesthesia ◽  
Fracture Surgery

The superiority of distinct anesthesia methods for geriatric hip fracture surgery remains unclear. We evaluated high mobility group box-1 (HMGB1) and interleukin-6 (IL-6) with three different anesthesia methods in elderly patients undergoing hip fracture surgery. Routine blood test findings, postoperative morbidity, and mortality were assessed as secondary outcome. In total, 176 patients were randomized into desflurane (n = 60), propofol (n = 58), or spinal groups (n = 58) that received desflurane-based balanced anesthesia, propofol-based total intravenous anesthesia (TIVA), or spinal anesthesia, respectively. The spinal group required less intraoperative vasopressors (p < 0.001) and fluids (p = 0.006). No significant differences in HMGB1 (pgroup×time = 0.863) or IL-6 (pgroup×time = 0.575) levels were noted at baseline, postoperative day (POD) 1, or POD2. Hemoglobin, albumin, creatinine, total lymphocyte count, potassium, troponin T, and C-reactive protein were comparable among groups at all time-points. No significant differences in postoperative hospital stay, intensive care unit (ICU) stay, and ventilator use among groups were observed. Postoperative pulmonary, cardiac, and neurologic complications; and in-hospital, 30-day, and 90-day mortality were not significantly different among groups (p = 0.974). In conclusion, HMGB1 and IL-6, and all secondary outcomes, were not significantly different between desflurane anesthesia, propofol TIVA, and spinal anesthesia.

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