Effect of anaesthesia on cemented hemiarthroplasty –A multicentre retrospective study (TRON study)–

Hip fracture, including femoral neck fracture (FNF), is a cause for concern in elderly (≥75 years of age) patients, as it is one of the most common types of traumatic injuries in this patient group, ad it is associated with high rates of mortality and functional loss [1]. Most hip fractures are treated surgically, which requires anaesthesia, and has a severe impact on morbidity and mortality in the geriatric population [2].

Cemented hemiarthroplasty (HA) is recommended in cases of bone fragility or poor stem fit in displaced FNF in elderly patients. A potential advantage of cement is less postoperative mid-thigh pain because the femoral stem is more firmly fixed within the femur [3]. On the other hand, decreased oxygenation in the insertion of the prostheses during hip arthroplasty [4], and decreased oxygenation and blood pressure during cementation, called bone cement implantation syndrome (BCIS) [1], have been reported.

Regarding anaesthetic techniques during the surgical repair of FNF, a Cochrane review of 31 RCTs (n = 3231) of proximal femoral fractures concluded that there were no significant differences in 30-day mortality or the incidence of pneumonia between general and regional (spinal and epidural) anaesthesia [5]. In contrast, it is reported that the incidence of respiratory-specific morbidities, including pneumonia, the acute exacerbation of chronic obstructive pulmonary disease (COPD), and respiratory failure was significantly higher in patients who received general anaesthesia (6.6%) than in those who received spinal anaesthesia [6].

Thus, although some reports have examined the use of cement and anaesthesia in HA for FNF, the relationship between the two is not clear. This study examines the life outcomes, complications, and walking ability of elderly patients who receive cemented HA according to the anaesthesia method.

留言 (0)

沒有登入
gif