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Comparison of Anesthetic Administration According to Method of Hip Surgery
Aysin Ersoy Esenyel1, Cem Zeki Esenyel2, Zekeriya Ervatan1
1Clinic of Anaesthesiology and Intensive Care, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
Insights
Anesthetic methods for hip surgery vary by procedure. Total hip prosthesis (THP) favored general anesthesia, while proximal femoral nail (PFN) preferred regional anesthesia, impacting patient outcomes.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
Background:
- Hip surgery encompasses procedures like total hip prosthesis (THP), partial hip prosthesis (PHP), and proximal femoral nail (PFN).
- Anesthetic management is a critical factor influencing patient outcomes in these procedures.
Purpose of the Study:
- To compare anesthetic methods used in THP, PHP, and PFN procedures.
- To identify associations between anesthetic choice and patient/procedural characteristics.
Main Methods:
- Retrospective analysis of 850 hip surgery patients categorized into PHP, PFN, and THP groups.
- Evaluation of anesthesia type, intraoperative interventions, complications, and patient demographics (age, ASA score).
Main Results:
- THP patients were younger; PFN procedures had shorter durations.
- General anesthesia was more common in THP, while regional anesthesia dominated PFN.
- THP had higher blood transfusion rates and antihypertensive use; PFN used more colloids.
Conclusions:
- Anesthetic selection for hip surgery should be tailored to the specific procedure (THP, PHP, PFN).
- Consideration of operation duration, patient age, and blood loss is crucial for optimal anesthetic choice.
Objective:
The aim of this study is to compare total hip prosthesis (THP), partial hip prosthesis (PHP), and proximal femoral nail (PFN) patients in terms of the chosen anesthetic method.
Methods:
A total of 850 patients who underwent hip surgery were divided into 3 groups according to the operation type: PHP (n=281), PFN (n=393), and THP (n=176). The type of anesthesia administered, interventions during anesthesia, and complications were retrospectively evaluated. The groups were compared in terms of patient age, American Society of Anesthesiologists (ASA) scores, chosen anesthetic method, operation duration, colloid use during operation, use of antihypertensive medication, use of vasoconstrictor medication, development of hypotension, blood transfusion administered, development of cardiac arrest, requirements for intensive care after operation, and use of a central catheter.
Results:
In the THP group, the mean age of patients was significantly lower as compared to the PHP and PFN groups. The duration of operation was lower in the PFN group as compared to the other two groups. In the THP group, general anesthesia was significantly high, while in the PFN group, regional anesthetic administration was high. While colloid use was greater in the PFN group, the blood transfusion rate was higher in the THP group. The use of antihypertensive medication was higher in the THP group as compared to the other groups.
Conclusion:
Although all three anesthetic methods could be used in hip surgery, the type of anesthesia should be chosen according to the type of hip surgery considering the duration of operation, age of the patient, and blood lost during the operation.