Anesthesia and Perioperative Complications for Hip Arthroplasty in Geriatrics: a Retrospective Study

Shin, Yang Sik; Lee, Ki Young; Kim, Jong Hoon; Lee, Jong Yeon

Abstract

BACKGROUND: Geriatric patients undergoing hip arthroplasty are generally considered to be at high risk for anesthesia and surgery. Thus, the evaluation of safe anesthetic methods for hip arthroplasty in geriatric patients is important and necessary.
METHODS
228 geriatrics, either sex, older than 65 years, who were performed hip arthroplasty from Mar. 1985 to Jun. 1995, were investigated for anesthetic techniques, postoperative complications and the other problems, retrospectively. According to the kinds of anesthetic techniques, the items including primary indication for operation, name of operation, blood loss, perioperative complications, time from the end of operation to the first analgesic requirement and frequency of analgesic requirements for postoperative 72 hours were analyzed.
RESULTS
The mean age of the patients with caudal anesthesia was significantly higher than that with general inhalation anesthesia. The blood loss in patients with epidural anesthesia was significantly more than that in hypobaric spinal anesthesia. The most frequent perioperative complications were cardiovascular problems including hypotension, hypertension, arrythmias, and myocardial infarction. The numbers of analgesic requirement within the postoperative 72 hours was the lowest in epidural anesthesia. There was one postoperative fatal case, whose the cause of death was found to pulmonary thromboembolism by autopsy.
CONCLUSIONS
This study suggested that there were many risks for anesthesia and operation in geriatric patients with hip arthroplasty, and the cardiovascular complications were the most frequent. Thus, for hip arthroplasty in geriatrics, the choice of optimal anesthetic techniques depending on the patients physical status and physicians skill should be emphasized with the proper perioperative anesthetic management.