scholarly journals Changes in post-operative renal function and coagulation profile after hydroxyethyl starch administration in patients undergoing orthopedic hip surgery under spinal anesthesia

2021 ◽  
Vol 12 (11) ◽  
pp. 163-168
Author(s):  
Kirti Kamal ◽  
Monika Bhandari ◽  
Priyanka Bansal ◽  
Geeta Ahlawat ◽  
Renu Bala ◽  
...  
Keyword(s):  
Renal Function ◽  
Elderly Patients ◽  
Prospective Study ◽  
Spinal Anesthesia ◽  
Hydroxyethyl Starch ◽  
Hip Surgery ◽  
Physical Status ◽  
Coagulation Profile ◽  
Significant Difference ◽  
Group Allocation

Background: Hydroxyethyl starch solutions which have been introduced some three decades ago, have been extensively used for treatment of intraoperative hypovolaemia. Aims and Objectives: The present prospective study was conducted to study changes in post-operative renal function and coagulation profile in patients undergoing orthopedic hip surgery under spinal anesthesia after coloading with 6% HES 130/0.4. Materials and Methods: Seventy patients, aged between 50 and 80 years, of either sex, belonging to ASA physical Status I and II, scheduled for orthopedic hip surgery under spinal anesthesia were included in the study. As per the group allocation, coloading was done with 7.5 mlkg-1 of either Group RL or 6% 130/0.4 Group HES during the 1st h of surgery. Venous samples were withdrawn before the day of surgery, on the day of surgery, and on the 3rd day of surgery. Results: No statistically significant difference between renal and coagulation profile was found among groups. Conclusion: Thus, we recommend using tetrastarch (6% HES 130/0.4) for intraoperative hypovolemia in elderly patients with normal renal function and coagulation profile undergoing orthopedic hip surgery.

scholarly journals Observation of single spinal anesthesia by 25G needle puncture through a lateral crypt for hip surgery in elderly patients

Medicine ◽  
2019 ◽  
Vol 98 (27) ◽  
pp. e16334
Author(s):  
Zairong Tang ◽  
Cheng Zhang ◽  
Zhifei Xu ◽  
Feng Jin ◽  
Dongliang Liang
Keyword(s):  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Hip Surgery ◽  
Needle Puncture ◽  
Surgery In Elderly

Microvascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis

2011 ◽  
Vol 114 (1) ◽  
pp. 172-179 ◽  
Author(s):  
Raymond F. Sekula ◽  
Andrew M. Frederickson ◽  
Peter J. Jannetta ◽  
Matthew R. Quigley ◽  
Khaled M. Aziz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Trigeminal Neuralgia ◽  
Elderly Patients ◽  
Prospective Study ◽  
Microvascular Decompression ◽  
Cranial Nerve ◽  
Meta Analysis ◽  
Complication Rates ◽  
Significant Difference

Object Because the incidence of trigeminal neuralgia (TN) increases with age, neurosurgeons frequently encounter elderly patients with this disorder. Although microvascular decompression (MVD) is the only etiological therapy for TN with the highest initial efficacy and durability of all treatments, it is nonetheless associated with special risks (cerebellar hematoma, cranial nerve injury, stroke, and death) not seen with the commonly performed ablative procedures. Thus, the safety of MVD in the elderly remains a concern. This prospective study and systematic review with meta-analysis was conducted to determine whether MVD is a safe and effective treatment in elderly patients with TN. Methods In this prospectively conducted analysis, 36 elderly patients (mean age 73.0 ± 5.9 years) and 53 nonelderly patients (mean age 52.9 ± 8.8 years) underwent MVD over the study period. Outcome and complication data were recorded. The authors also conducted a systematic review of the English literature published before December 2009 and providing outcomes and complications of MVD in patients with TN above the age of 60 years. Pooled complication rates of stroke, death, cerebellar hematoma, and permanent cranial nerve deficits were analyzed. Results Thirty-one elderly patients (86.1%) reported an excellent outcome after MVD (mean follow-up 20.0 ± 7.0 months). Twenty-five elderly patients with Type 1 TN were compared with 26 nonelderly patients with Type 1 TN, and no significant difference in outcomes was found (p = 0.046). Three elderly patients with Type 2a TN were compared with 12 nonelderly patients with Type 2a TN, and no significant difference in outcomes was noted (p = 1.0). Eight elderly patients with Type 2b TN were compared with 15 nonelderly patients with Type 2b TN, and no significant difference in outcomes was noted (p = 0.086). The median length of stay between cohorts was compared, and no significant difference was noted (2 days for each cohort, p = 0.33). There were no CSF leaks, no cerebellar hematomas, no strokes, and no deaths. Eight studies (1334 patients) met the inclusion criteria for the meta-analysis. For none of the complications was the incidence significantly more frequent in elderly patients than in the nonelderly. Conclusions Although patient selection remains important, the authors' experience and the results of this systematic review with meta-analysis suggest that the majority of elderly patients with TN can safely undergo MVD.

scholarly journals A prospective study of hepatic safety of statins used in very elderly patients

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Meizi Guo ◽  
Junli Zhao ◽  
Yingjiu Zhai ◽  
Panpan Zang ◽  
Qing Lv ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis B ◽  
Elderly Patients ◽  
Prospective Study ◽  
Statin Therapy ◽  
Statin Treatment ◽  
Hepatitis B Infection ◽  
Very Elderly ◽  
Significant Difference ◽  
The Impact

Abstract Background Statins play an important role in the care of patients with cardiovascular disease and have a good safety record in clinical practice. Hepatotoxicity is a barrier that limits the ability of primary care physicians to prescribe statins for patients with elevated liver transaminase values and/or underlying liver disease. However, limited population-based data are available on the use of statin therapy and on the hepatotoxicity of statins in very elderly patients. This prospective study evaluated the liver enzyme elevation during statin therapy in very elderly patients (≥80 years old). Methods Patients with hypercholesterolemia (LDL-C levels ≥3.4 and < 5.7 mmol/L), atherosclerosis, coronary heart disease (CHD), or a CHD-risk equivalent were enrolled and received once-daily statin treatment. Multivariate logistic regression models were used to study the impact of age, gender, hepatitis B infection, fatty liver disease, biliary calculus, other chronic diseases, drug kinds, alcohol abuse, statin variety, and statin dose variables. Results A total of 515 consecutive patients ranging from 80 to 98 years old were included in the analysis. These patients were treated with simvastatin, fluvastatin, pravastatin, rosuvastatin, or atorvastatin. Twenty-four patients (4.7, 95% CI 2.7–6.6) showed an increase in their hepatic aminotransferase levels. No significant difference of hepatic aminotransferase elevation rates was observed in different statin treatment groups. The incidence of mild, moderate, and severe elevation of aminotransferase levels was 62.5% (15/24), 29.2% (7/24), and 8.3% (2/24), respectively. None of the patients developed hepatic failure. Nine patients with moderate or severe aminotransferase elevations discontinued therapy. The time of onset of hepatic aminotransferase elevation ranged from 2 weeks to 6 months after statin treatment. The onset of hepatic aminotransferase elevation was within 1 month for 70.8% of patients. The patients took 2 weeks to 3 months to recover their liver function after statin therapy cessation. Multivariate analysis identified chronic hepatitis B infection and alcohol consumption as independent factors associated with the hepatic response to statins: OR, 12.83; 95% CI (4.36–37.759) and OR, 2.736; 95% CI (1.373–5.454), respectively. Conclusion The prevalence of elevated transaminases was higher than published data in very elderly patients. Overall, statin treatment is safe for patients ≥80 years old.

Favorable coagulation profile with fondaparinux after hip surgery in elderly patients

2009 ◽  
Vol 90 (4) ◽  
pp. 476-482 ◽  
Author(s):  
Zuzana Kudrnová ◽  
Jan Kvasnička ◽  
Karel Kudrna ◽  
Jiří Mazoch ◽  
Ivana Malíková ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hip Surgery ◽  
Coagulation Profile ◽  
Surgery In Elderly

scholarly journals Value of Transthoracic Echocardiography in the Prediction of Post-spinal Anesthesia Hypotension

2020 ◽  
Author(s):  
Ferdi Gülaştı ◽  
Sevil Gülaştı ◽  
İbrahim Girgin ◽  
Sinem Sarı
Keyword(s):  
Spinal Anesthesia ◽  
Transthoracic Echocardiography ◽  
Physical Status ◽  
Global Function ◽  
Inguinal Hernia Operation ◽  
Significant Difference ◽  
The Status ◽  
Hernia Operation ◽  
The Difference ◽  
Diastolic Functions

INTRODUCTION: Spinal Anesthesia (SA) can lead to hypotension due to sympathic denervation, which causes a reduction in venous return to the heart as a result of peripheral vasodilation and redistribution of intravascular blood. Transthoracic Echocardiography (TTE) is a noninvasive and easy-to-use method to visualize cardiac reserve and functions. We aimed to evaluate whether parameters attained via transthoracic echocardiography are predictive of development of post-SA hypotension. METHODS: Forty-two patients between the ages of 18 and 80, who would undergo inguinal hernia operation under SA, with ASA physical status I-II and had no clinically recognized cardiovascular disease, were included in the study. TTE was performed for each patient 30 minutes before the operation, and measurements were recorded along with the intraoperative hemodynamic parameters. RESULTS: There was a statistically significant difference between the medians of left ventricle end-diastolic diameter (LVEDD) (cm) according to the status of post-SA hypotension (p=0.003).Accordingly, median LVEDD of patients who did not develop hypotension was significantly larger compared with that of those who had hypotension. Similarly, a statistically significant difference emerged between the medians of right ventricular (RV) tricuspid annular plane systolic excursion (TAPSE) (cm) showing RV global function according to the status of post-SA hypotension (p=0.001). Accordingly, patients who did not have hypotension had a larger RV-TAPSE median compared with that of those who had hypotension. The difference between the medians of RV isovolumetric relaxation time (RV-IVRT), which is one of the indicators of RV diastolic functions was again statistically significant according to the status of post-SA hypotension (p=0.025). DISCUSSION AND CONCLUSION: TAPSE, RV-IVRT and LVEDD measured via preoperative TTE, can be significant parameters to predict the development of post-SA hypotension.

scholarly journals Postoperative Renal Function Evaluation, through RIFLE Criteria, of Elderly Patients Who Underwent Femur Fracture Surgery under Spinal Anesthesia

Renal Failure ◽  
2008 ◽  
Vol 30 (5) ◽  
pp. 485-490 ◽  
Author(s):  
Vera Lucia Fernandes Azevedo ◽  
Marco Antonio Santos Silveira ◽  
Jedson Nascimento Santos ◽  
José Reinaldo Cerqueira Braz ◽  
Leandro Gobbo Braz ◽  
...  
Keyword(s):  
Renal Function ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Femur Fracture ◽  
Function Evaluation ◽  
Rifle Criteria ◽  
Postoperative Renal Function ◽  
Fracture Surgery

scholarly journals Comparison of unilateral spinal and continous spinal anesthesia for hip surgery in elderly patients

2013 ◽  
Vol 7 (4) ◽  
pp. 404 ◽  
Author(s):  
GUlufer Sivrikaya ◽  
Birsen Eksioglu ◽  
Ayse Hanci ◽  
Hale Dobrucali ◽  
LeylaT Kilinc
Keyword(s):  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Hip Surgery ◽  
Surgery In Elderly

scholarly journals Effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia, 2018; prospective cohort study.

2020 ◽  
Author(s):  
Moges Gelaw Taye ◽  
Lidya Haddis ◽  
Meron Abrar ◽  
Adugna Aregawi ◽  
Eyayalem Melese
Keyword(s):  
Heart Rate ◽  
Cohort Study ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Induced Hypotension ◽  
Resource Limited ◽  
Significant Difference ◽  
Limited Setting

Abstract Background: Spinal anesthesia induced hypotension and bradycardia are common and hazardous in elderly patients. Many techniques are being tried to prevent and treat these problems even if there is a controversy. The effects of prophylactic atropine on prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics for urologic surgeries are not well-established. Objective: To assess the effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia from December 1, 2017 to February 28, 2018 G.C. Methods: This is a prospective cohort study that recruits 76 patients who underwent elective urological surgeries. Independent t-test and Manny Whitney tests were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant. Results: There was no significant difference in baseline heart rate, mean arterial pressure, type & duration of surgery and total fluid administrations. There was a statistically significant difference in mean heart rate and mean arterial pressure at different times of measurement between the exposed and un-exposed groups. Total one hour vasopressor consumption was minimal in the exposed group (P = 0.038). Conclusion: Prophylactic atropine with in one minute of induction of spinal anesthesia in elderly patients undergoing urological surgery might reduce the incidence of hypotension and bradycardia.

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