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Total intravenous anesthesia for geriatric hip fracture with severe systemic disease.
- Source :
- European Journal of Trauma & Emergency Surgery; Oct2023, Vol. 49 Issue 5, p2139-2145, 7p, 1 Diagram, 2 Charts
- Publication Year :
- 2023
-
Abstract
- Purpose: Our study aimed to determine the impact of a novel technique of anesthesia administration on the clinical outcomes and complications in geriatric patients with severe systemic disease undergoing hip surgery. Methods: We retrospectively identified patients aged > 65 years with severe systemic disease that was a constant of life [American Society of Anesthesiologists (ASA) IV] who underwent surgery for hip fracture between January 2018 and January 2020. The patients were divided into two groups: Group I [fascia iliaca compartment block plus propofol-based total intravenous anesthesia (FICB + TIVA)] and Group II [general anesthesia (GA)]. The primary outcomes were 30-day and 1-year mortality. The secondary outcomes included length of hospital stay, length of intensive care unit (ICU) stay, postoperative morbidity, Visual Analog Scale score, and consumption of analgesics. Results: There was no significant difference in the 30-day mortality (5 vs. 3.8%, p = 0.85) and 1-year mortality (15 vs. 12%, p = 0.73) between the groups. Group I had significantly lower ICU requirements (p = 0.01) and shorter lengths of ICU stay (p < 0.001) and hospital stay (p < 0.001). Moreover, a smaller proportion of patients in Group I required postoperative morphine or oral opiates. Conclusion: Geriatric patients who underwent hip surgery under FICB + TIVA required fewer ICU admissions, shorter lengths of ICU and hospital stay, and had lesser postoperative opioid consumption than those who were under GA. Hence, we recommend the novel FICB + TIVA technique for hip fracture surgery in geriatric patients with poor general health status and high surgical risks (ASA IV). [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 18639933
- Volume :
- 49
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- European Journal of Trauma & Emergency Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 172329426
- Full Text :
- https://doi.org/10.1007/s00068-023-02291-z