Anesthetic Techniques in Octogenarians and Older Undergoing Orthopedic Surgery for Hip Fracture

Year 2017, , 85 - 89, 30.09.2017

Onur Palabıyık , Fikret Bayar Tugba Caglar

https://doi.org/10.5799/jcei.343194

Abstract

Objectives: Hip fracture is common orthopedic problems for patients aged 80 years and older.
Because of their decreased cardiopulmonary capacity, an optimal anesthetic technique should
be chosen by anesthesiologists. The purpose of the present study is to analyze anesthetic
techniques and related postoperative mortality in octogenarians and older who underwent hip
fractures surgery.
Patients and Methods: We analyzed hip fracture surgeries and identified patients aged 80
years and older between January 2012 and December 2013. Patient age, gender, coexisting
diseases, American Society of Anesthesiologists (ASA) Physical Status classification, anesthetic
technique, hematocrit, hemoglobin, total lymphocyte count (TLC), the length of surgery,
intraoperative blood transfusion requirements, postoperative discharge ward, the length of
postoperative hospital stay, and postoperative status were recorded.
Results: We retrospectively identified 106 patients aged 80 years and older underwent hip
fracture surgeries. Six (5.6%), 36 (34.0%), 2 (1.9%), 53 (50.0%), and 9 (8.5%) of procedures were
performed under general anesthesia (GA), spinal anesthesia (SA), epidural anesthesia, combined
spinal-epidural anesthesia (CSEA), and peripheral nerve block (PNB), respectively. The
postoperative 7 and 30-day mortality were 6.6% and 10.4%, respectively. Age, gender, ASA,
hematocrit, hemoglobin, TLC, discharge to the ward, the length of postoperative hospital stay,
and the postoperative mortality rates were similar between the GA, SA, CSEA, and PNB. There
was no relationship between postoperative mortality and anesthetic technique.
Conclusion: In octogenarians and older, the postoperative mortality is higher after hip fracture
and is not associated with the anesthetic technique. 

Keywords

Octogenarians, general anesthesia, central neuraxial block, peripheral nerve block, mortality

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