Yıl: 2018 Cilt: 25 Sayı: 4 Sayfa Aralığı: 698 - 703 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2018.07.138 İndeks Tarihi: 13-05-2019

Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study

Öz:
Aim: To determine the optimum anesthetic technique, namely general or regional anesthesia, for elderly patients over 80 years old with hip fracture surgery with respect to demographic characteristics, hemodynamics, length of hospital stay, and mortality.Material and Methods: Patients with the American Society of Anesthesiology (ASA) scores of II–IV aged over 80 years old were included in our study. The patients were retrospectively allocated to two cohort study groups: regional anesthesia (Group GA, n=41) and general anesthesia (Group RA, n=19). The demographic characteristics, hemodynamics, length of hospital stay, and mortality were recorded.Results: The two groups were similar with respect to age, sex, height, weight, body mass index, ideal body weight, ASA scores, and smoking. The number of patients using drugs in Group RA was significantly more than Group GA. The need for invasive arterial monitorization, central venous catheter, and nasogastric tube in Group RA were significantly less. The duration of anesthesia and surgery in Group RA were significantly shorter than Group GA. The length of ICU and hospital stays in Group RA were significantly shorter than Group GA. Hospital mortality of Group GA was significantly higher than that in Group RA.Conclusion: The present retrospective cohort study showed that perioperative complications, duration of anesthesia and surgery, admission to the postoperative ICU, length of ICU and hospital stay, and also mortality in regional anesthesia were significantly lower in comparison with general anesthesia. We therefore conclude that regional anesthesia can be used safely with patients during hip fracture surgery.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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  • Konttinen N, Rosenberg PH. Outcome after anaesthesia and emergency surgery in patients over 100 years old. Acta Anaesthesiol Scand 2006;50:283-9.
  • Cheng SY, Levy AR, Lefaivre KA, et al. Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int 2011; 22:2575-86.
  • Melton LJ 3rd. Hip fractures: a worldwide problem today and tomorrow. Bone 1993;14:S1-8.
  • Parker MJ, Handoll HH, Griffiths R. Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev 2004;18: CD000521.
  • Oztürk I, Toker S, Ertürer E, et al. Analysis of risk factors affecting mortality in elderly patients (aged over 65 years) operated on for hip fractures. Acta Orthop Traumatol Turc 2008;42:16-21.
  • Bilsel K, Erdil M, Gulabi D, et al. Factors affecting mortality after hip fracture surgery: a retrospective analysis of 578 patients. Eur J Orthop Surg Traumatol 2013;23:895-900.
  • Modig J, Borg T, Bagge L, et al. Role of extradural and of general anaesthesia in fibrinolysis and coagulation after total hip replacement. British Journal of Anaesthesia 1983;55:625-9.
  • Winnie AP, Ramamurthy S, Durrani Z, et al. Plexus blocks for lower extremity surgery. Anesthesiology Reviews 1974;1:11-6.
  • Mansour NY. Reevaluating the sciatic nerve block: another landmark for consideration. Regional Anesthesia 1993;18:322-3.
  • Schulz KF, Altman DG, Moher D; CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg 2011;9:672-7.
  • Ercin E, Bilgili MG, Sari C, et al. Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients.Eur J Orthop Surg Traumatol 2017;27:101-6.
  • Jin J, Wang G, Gong M, et al. Retrospective comparison of the effects of epidural anesthesia versus peripheral nerve block on postoperative outcomes in elderly Chinese patients with femoral neck fractures.Clin Interv Aging. Aug 2015;10:1223-31.
  • Matsuo M, Yamagami T, Higuchi A. Impact of age on postoperative complication rates among elderly patients with hip fracture: a retrospective matched study. J Anesth 2018;32:452-6.
  • Bigler D, Adelhøj B, Petring OU, et al. Mental function and morbidity after acute hip surgery during spinal and general anaesthesia. Anaesthesia 1985;40:672-6.
  • Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. Br J Anaesth 2000;84:450-5.
  • Eger EI 2nd. General versus regional anaesthesia for hip fracture surgery. Br J Anaesth 2000;85:492.
  • Neuman MD, Rosenbaum PR, Ludwig JM, et al. Anesthesia technique, mortality, and length of stay after hip fracture surgery. JAMA 2014;311:2508-17.
  • Brox WT, Chan PH, Cafri G, et al. Similar mortality with general or regional anesthesia in elderly hip fracture patients. Acta Orthop 2016;87:152-7.
APA Akbas S, ÖZKAN A (2018). Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. , 698 - 703. 10.5455/annalsmedres.2018.07.138
Chicago Akbas Sedat,ÖZKAN Ahmet Selim Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. (2018): 698 - 703. 10.5455/annalsmedres.2018.07.138
MLA Akbas Sedat,ÖZKAN Ahmet Selim Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. , 2018, ss.698 - 703. 10.5455/annalsmedres.2018.07.138
AMA Akbas S,ÖZKAN A Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. . 2018; 698 - 703. 10.5455/annalsmedres.2018.07.138
Vancouver Akbas S,ÖZKAN A Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. . 2018; 698 - 703. 10.5455/annalsmedres.2018.07.138
IEEE Akbas S,ÖZKAN A "Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study." , ss.698 - 703, 2018. 10.5455/annalsmedres.2018.07.138
ISNAD Akbas, Sedat - ÖZKAN, Ahmet Selim. "Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study". (2018), 698-703. https://doi.org/10.5455/annalsmedres.2018.07.138
APA Akbas S, ÖZKAN A (2018). Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. Annals of Medical Research, 25(4), 698 - 703. 10.5455/annalsmedres.2018.07.138
Chicago Akbas Sedat,ÖZKAN Ahmet Selim Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. Annals of Medical Research 25, no.4 (2018): 698 - 703. 10.5455/annalsmedres.2018.07.138
MLA Akbas Sedat,ÖZKAN Ahmet Selim Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. Annals of Medical Research, vol.25, no.4, 2018, ss.698 - 703. 10.5455/annalsmedres.2018.07.138
AMA Akbas S,ÖZKAN A Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. Annals of Medical Research. 2018; 25(4): 698 - 703. 10.5455/annalsmedres.2018.07.138
Vancouver Akbas S,ÖZKAN A Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study. Annals of Medical Research. 2018; 25(4): 698 - 703. 10.5455/annalsmedres.2018.07.138
IEEE Akbas S,ÖZKAN A "Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study." Annals of Medical Research, 25, ss.698 - 703, 2018. 10.5455/annalsmedres.2018.07.138
ISNAD Akbas, Sedat - ÖZKAN, Ahmet Selim. "Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study". Annals of Medical Research 25/4 (2018), 698-703. https://doi.org/10.5455/annalsmedres.2018.07.138