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一位107岁患者成功实施麻醉及髋关节手术。

Successful anesthesia and hip surgery in a 107-year-old patient.

作者信息

Imbelloni Luiz Eduardo, Lima Umberto, Pedrosa Francisco Kartney

机构信息

Department of Anesthesiology, Faculdade de Medicina Nova Esperança, João Pessoa, Brazil.

Department of Orthopaedics, Complexo Hospitalar Mangabeira, João Pessoa, Brazil.

出版信息

Am J Case Rep. 2014 Jul 22;15:308-11. doi: 10.12659/AJCR.889961.

Abstract

PATIENT

Female, 107.

FINAL DIAGNOSIS

Hip fracture.

SYMPTOMS

-.

MEDICATION

-.

CLINICAL PROCEDURE

Hip surgery.

SPECIALTY

Orthopedics and Traumatology.

OBJECTIVE

Rare disease.

BACKGROUND

In modern societies, elderly populations have increased over the last four decades and have become the main clients of medical services. A hip fracture is a significant injury for anyone, but for older people it can be catastrophic.

CASE REPORT

A 107-year-old female was admitted with fracture of the right hip. The patient took a single 200 mL carbohydrate drink orally two hours before surgery. Before induction of spinal anesthesia, routine monitoring was started and an intravenous line was placed. Crystalloids and hydroxyethyl starch in 0.9% sodium chloride solution were administered intravenously during the operation. After sedation with i.v. ketamine and midazolam, spinal puncture was performed with the patient in the sitting position and isobaric bupivacaine were administered. The level of sensory block was observed in T12 and motor blockade (grade 3) of the lower limbs. The surgical procedure lasted 60 minutes without hypotension, bradycardia or decreased oxygen saturation. For safety reason, the patient was transferred to the ICU for monitoring; intravenous hydration was withdrawn and released oral feeding six hours after the end of surgery. The patient was sent to his residence on the morning of the second day.

CONCLUSIONS

This case showed that with suitable techniques and conduits can perform surgery in a patient with 107 years.

摘要

患者

女性,107岁。

最终诊断

髋部骨折。

症状

无。

用药

无。

临床操作

髋关节手术。

专科

骨科学与创伤学。

目的

罕见病。

背景

在现代社会,过去四十年来老年人口有所增加,并已成为医疗服务的主要对象。髋部骨折对任何人来说都是严重的损伤,但对老年人而言可能是灾难性的。

病例报告

一名107岁女性因右髋部骨折入院。患者在手术前两小时口服了一杯200毫升的碳水化合物饮料。在诱导脊髓麻醉前,开始常规监测并放置静脉输液管。术中静脉输注晶体液和0.9%氯化钠溶液中的羟乙基淀粉。静脉注射氯胺酮和咪达唑仑镇静后,患者取坐位进行脊髓穿刺,并给予等比重布比卡因。观察到感觉阻滞平面在T12,下肢运动阻滞(3级)。手术过程持续60分钟,未出现低血压、心动过缓或血氧饱和度下降。出于安全考虑,患者被转入重症监护病房进行监测;手术结束6小时后停止静脉补液并开始经口喂养。患者于第二天上午被送回家中。

结论

该病例表明,采用合适的技术和管理方法,可以为一名107岁的患者进行手术。

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