Effect of Anesthesia Technique on Outcome After Hip Fracture Surgery in Elderly Adult Patients
Overview
- Phase
- Not Applicable
- Intervention
- Bupivacaine
- Conditions
- Hip Fracture
- Sponsor
- Yonsei University
- Enrollment
- 186
- Locations
- 1
- Primary Endpoint
- HMGB1
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Despite many previous studies, whether anesthetic technique will significantly affect overall patient outcome, morbidity and mortality in elderly hip fracture patients is controversial. Due to old age, poor patient condition and emergent clinical settings, patients undergoing surgical procedures for hip fracture management are often subject to poor postoperative outcome and high mortality rates. While many studies have reported that regional anesthesia leads to improved postoperative outcome after hip fracture surgery, others have concluded otherwise. Moreover, because the majority of these previous studies are retrospective cohorts or systemic reviews, there is a need for randomized clinical trials to provide high quality evidence. This study aims to compare patient outcome between three different anesthetic techniques in elderly patients undergoing surgery for hip fracture management by evaluating proinflammatory cytokines, chemistry lab testing and clinical outcome between general anesthesia with either desflurane or propofol-based TIVA and spinal anesthesia with bupivacaine.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients older than 65 years scheduled for elective or emergency hip fracture surgery.
Exclusion Criteria
- •Patient refusal
- •Inflammation or wound at puncture site, increased intracranial pressure, bleeding diathesis
- •Allergies to propofol or its ingredients, soybeans or peanuts
- •Patients with altered mental status
- •Illiterate patients or foreigners
Arms & Interventions
Group S
Spinal anesthesia with 0.5% bupivacaine
Intervention: Bupivacaine
Group D
General anesthesia with desflurane
Intervention: Desflurane
Group P
General anesthesia with propofol total intravenous anesthesia
Intervention: Propofol
Outcomes
Primary Outcomes
HMGB1
Time Frame: from preoperative baseline to 72hours
IL-6
Time Frame: from preoperative baseline to 72hours
NT-proBNP
Time Frame: from preoperative baseline to 72hours
hemoglobin
Time Frame: from preoperative baseline to 72hours
total lymphocyte count
Time Frame: from preoperative baseline to 72hours
albumin
Time Frame: from preoperative baseline to 72hours
creatinine
Time Frame: from preoperative baseline to 72hours
potassium
Time Frame: from preoperative baseline to 72hours
troponin-T
Time Frame: from preoperative baseline to 72hours
CRP
Time Frame: from preoperative baseline to 72hours