Total intravenous anesthesia for geriatric hip fracture with severe systemic disease
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 system...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2023-10, Vol.49 (5), p.2139-2145 |
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| container_title | European journal of trauma and emergency surgery (Munich : 2007) |
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| creator | Huang, Yu-Yi Hui, Chung-Kun Lau, Ngi-Chiong Ng, Yuet-Tong Lin, Tung-Yi Chen, Chien-Hao Wang, Ying-Chih Tang, Hao-Che Chen, Dave Wei-Chih Chang, Chia-Wei |
| description | 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
|
| doi_str_mv | 10.1007/s00068-023-02291-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10520204</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2868474013</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-f7329247f786e74d5990f1185e4191bb7f915e89713659a75bfb2c833717ca913</originalsourceid><addsrcrecordid>eNp9kUFP3DAQha2qqFDoH-gBReqFS4rHdmL7VKEV0EpIXJaz5WTHrFE22drJIvj1HVi6pRw4WB5pvnn2m8fYV-DfgXN9mjnntSm5kHSEhfLxAzsAU8vSWgUfd7WU--xzzndE87oSn9i-1LJSUsEBm8-H0XdF7MfkN9gPUy58j3lcYo6-CEMqbjFFP6bYFsu4LkLy7TglLO7juCwybpDq_JBHXBGxiBl9xiO2F3yX8cvLfchuLs7ns5_l1fXlr9nZVdkqUY9l0FJYoXTQpkatFpW1PACYChVYaBodLFRorAZZV9brqgmNaI2UGnTrLchD9mOru56aFS5afHLRuXWKK58e3OCj-7_Tx6W7HTYOeCW44IoUTl4U0vB7It9uFXOLXUdLoF04YYRVkhtZE_rtDXo3TKknf0TVRmnFQRIltlSbhpwTht1vgLun1Nw2NUepuefU3CMNHb_2sRv5GxMBcgtkavWUyL-335H9A5C8o6U</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2868474013</pqid></control><display><type>article</type><title>Total intravenous anesthesia for geriatric hip fracture with severe systemic disease</title><source>Springer Online Journals Complete</source><creator>Huang, Yu-Yi ; Hui, Chung-Kun ; Lau, Ngi-Chiong ; Ng, Yuet-Tong ; Lin, Tung-Yi ; Chen, Chien-Hao ; Wang, Ying-Chih ; Tang, Hao-Che ; Chen, Dave Wei-Chih ; Chang, Chia-Wei</creator><creatorcontrib>Huang, Yu-Yi ; Hui, Chung-Kun ; Lau, Ngi-Chiong ; Ng, Yuet-Tong ; Lin, Tung-Yi ; Chen, Chien-Hao ; Wang, Ying-Chih ; Tang, Hao-Che ; Chen, Dave Wei-Chih ; Chang, Chia-Wei</creatorcontrib><description>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).</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-023-02291-z</identifier><identifier>PMID: 37354341</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anesthesia ; Critical Care Medicine ; Emergency Medicine ; Fractures ; Geriatrics ; Hip joint ; Intensive ; Medicine ; Medicine & Public Health ; Mortality ; Original ; Original Article ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Systemic diseases ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2023-10, Vol.49 (5), p.2139-2145</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-f7329247f786e74d5990f1185e4191bb7f915e89713659a75bfb2c833717ca913</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-023-02291-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-023-02291-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37354341$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Yu-Yi</creatorcontrib><creatorcontrib>Hui, Chung-Kun</creatorcontrib><creatorcontrib>Lau, Ngi-Chiong</creatorcontrib><creatorcontrib>Ng, Yuet-Tong</creatorcontrib><creatorcontrib>Lin, Tung-Yi</creatorcontrib><creatorcontrib>Chen, Chien-Hao</creatorcontrib><creatorcontrib>Wang, Ying-Chih</creatorcontrib><creatorcontrib>Tang, Hao-Che</creatorcontrib><creatorcontrib>Chen, Dave Wei-Chih</creatorcontrib><creatorcontrib>Chang, Chia-Wei</creatorcontrib><title>Total intravenous anesthesia for geriatric hip fracture with severe systemic disease</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>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).</description><subject>Anesthesia</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Fractures</subject><subject>Geriatrics</subject><subject>Hip joint</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original</subject><subject>Original Article</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Systemic diseases</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUFP3DAQha2qqFDoH-gBReqFS4rHdmL7VKEV0EpIXJaz5WTHrFE22drJIvj1HVi6pRw4WB5pvnn2m8fYV-DfgXN9mjnntSm5kHSEhfLxAzsAU8vSWgUfd7WU--xzzndE87oSn9i-1LJSUsEBm8-H0XdF7MfkN9gPUy58j3lcYo6-CEMqbjFFP6bYFsu4LkLy7TglLO7juCwybpDq_JBHXBGxiBl9xiO2F3yX8cvLfchuLs7ns5_l1fXlr9nZVdkqUY9l0FJYoXTQpkatFpW1PACYChVYaBodLFRorAZZV9brqgmNaI2UGnTrLchD9mOru56aFS5afHLRuXWKK58e3OCj-7_Tx6W7HTYOeCW44IoUTl4U0vB7It9uFXOLXUdLoF04YYRVkhtZE_rtDXo3TKknf0TVRmnFQRIltlSbhpwTht1vgLun1Nw2NUepuefU3CMNHb_2sRv5GxMBcgtkavWUyL-335H9A5C8o6U</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Huang, Yu-Yi</creator><creator>Hui, Chung-Kun</creator><creator>Lau, Ngi-Chiong</creator><creator>Ng, Yuet-Tong</creator><creator>Lin, Tung-Yi</creator><creator>Chen, Chien-Hao</creator><creator>Wang, Ying-Chih</creator><creator>Tang, Hao-Che</creator><creator>Chen, Dave Wei-Chih</creator><creator>Chang, Chia-Wei</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20231001</creationdate><title>Total intravenous anesthesia for geriatric hip fracture with severe systemic disease</title><author>Huang, Yu-Yi ; Hui, Chung-Kun ; Lau, Ngi-Chiong ; Ng, Yuet-Tong ; Lin, Tung-Yi ; Chen, Chien-Hao ; Wang, Ying-Chih ; Tang, Hao-Che ; Chen, Dave Wei-Chih ; Chang, Chia-Wei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-f7329247f786e74d5990f1185e4191bb7f915e89713659a75bfb2c833717ca913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anesthesia</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Fractures</topic><topic>Geriatrics</topic><topic>Hip joint</topic><topic>Intensive</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original</topic><topic>Original Article</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Systemic diseases</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Yu-Yi</creatorcontrib><creatorcontrib>Hui, Chung-Kun</creatorcontrib><creatorcontrib>Lau, Ngi-Chiong</creatorcontrib><creatorcontrib>Ng, Yuet-Tong</creatorcontrib><creatorcontrib>Lin, Tung-Yi</creatorcontrib><creatorcontrib>Chen, Chien-Hao</creatorcontrib><creatorcontrib>Wang, Ying-Chih</creatorcontrib><creatorcontrib>Tang, Hao-Che</creatorcontrib><creatorcontrib>Chen, Dave Wei-Chih</creatorcontrib><creatorcontrib>Chang, Chia-Wei</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Yu-Yi</au><au>Hui, Chung-Kun</au><au>Lau, Ngi-Chiong</au><au>Ng, Yuet-Tong</au><au>Lin, Tung-Yi</au><au>Chen, Chien-Hao</au><au>Wang, Ying-Chih</au><au>Tang, Hao-Che</au><au>Chen, Dave Wei-Chih</au><au>Chang, Chia-Wei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Total intravenous anesthesia for geriatric hip fracture with severe systemic disease</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>49</volume><issue>5</issue><spage>2139</spage><epage>2145</epage><pages>2139-2145</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><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><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37354341</pmid><doi>10.1007/s00068-023-02291-z</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1863-9933 |
| ispartof | European journal of trauma and emergency surgery (Munich : 2007), 2023-10, Vol.49 (5), p.2139-2145 |
| issn | 1863-9933 1863-9941 |
| language | eng |
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| source | Springer Online Journals Complete |
| subjects | Anesthesia Critical Care Medicine Emergency Medicine Fractures Geriatrics Hip joint Intensive Medicine Medicine & Public Health Mortality Original Original Article Sports Medicine Surgery Surgical Orthopedics Systemic diseases Traumatic Surgery |
| title | Total intravenous anesthesia for geriatric hip fracture with severe systemic disease |
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