Outcome after Anesthesia and Orthopedic Surgery in Patients Nonagenarians and Centenarians
- *Corresponding Author:
- Luiz Eduardo Imbelloni
Doctor of Anesthesiology Faculty of Medicine of Botucatu
School of Medicine Nova Esperança, João Pessoa-PB, Brazil
E-mail: [email protected]
Received Date: April 11, 2014; Accepted Date: June 15, 2014; Published Date: June 18, 2014
Citation: Imbelloni LE, Gouveia MA, de Morais Filho GB, da Silva A (2014) Outcome after Anesthesia and Orthopedic Surgery in Patients Nonagenarians and Centenarians. J Anesth Clin Res 5:411. doi: 10.4172/2155-6148.1000411
Copyright: © 2014 Imbelloni LE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: As life expectancy increases, the number of geriatric patients coming for surgery and anesthesia will make up an increasing portion of our practice. Nonagenarians and centenarians are a rapidly growing segment of the population. A hip fracture is a significant injury for anyone, but for older people it can be catastrophic. No previous study has used a national database to compare outcomes in these patients to those of other groups undergoing femur surgical procedures.
Methods: Between January 2012 and December 2013 inclusive, 47 patients (13 men and 34 women) aged 90 years and older (range, 90-107 years) with hip fracture were prospectively analyzed. Information on the preoperative condition of these patients, mode of anesthesia, drugs used, intra-operatively measured variables (e.g. hemodynamics, blood loss) and immediate post-operative variables measured in the post-anesthesia care unit (PACU), and first day of postoperative was obtained from the study protocol.
Results: Prior to injury, all of the patients were living at home. The average hospital stay until the day of surgery was 6.04 ± 2.77 days. The mean fasting time was 2:56 ± 0:38 hours. All patients were submitted to spinal anesthesia. The dose ranged from 6 to 15 mg, with a mean of 10 ± 2:43 mg isobaric bupivacaine. The duration of the spinal block was 2:56 ± 0:45 hours, the time for the use of dextrinomaltose was 2:14 ± 1:07 hours, the time in the PACU was 2:01 ± 0:43 hours and the time to reintroduce normal meals were 6:33 ± 1:03 hours. Arterial hypotension occurred in 3 patients and delirium in 5 patients. There were no deaths directly related to anesthesia or surgery.
Conclusion: Our prospective analysis shows that the nonagenarians and centenarians tolerated anesthesia and surgery, and can fully participate in projects accelerated postoperative recovery.