Bani Hani Diab A, Aleshawi Abdelwahab J, Al Shalakhti Majd H, Alhowary Alaa''a, Al-Jararahih Osama, Al-Mistarehi Abdel-Hameed, Yassin Ahmed
Department of Anesthesia and Recovery, Faculty of Medicine, Jordan University of Science and Technology, Irbid 21110, Jordan.
Faculty of Medicine, Jordan University of Science and Technology, Irbid 21110, Jordan.
Int J Gen Med. 2020 Jan 30;13:9-15. doi: 10.2147/IJGM.S232770. eCollection 2020.
Anesthesiologists prefer using general anesthesia (GA) in Parkinson's disease (PD). However, GA may mask neurological symptoms in the intraoperative period and exacerbate them postoperatively. Furthermore, the anesthetics used in GA have clear interactions with the drugs used to control PD. On the other hand, drugs used in spinal anesthesia (SA) might be safer for patients with PD. The aim of this study is to evaluate the effect of SA and GA in patients with PD who underwent hip fracture repairs.
Retrospectively, we identified those patients with PD who were admitted due to hip joint fracture. The following information were obtained: demographics, preoperative assessment information of the patients, type of anesthesia, and types of fractures and orthopedic procedures. In addition, intraoperative and postoperative complications were studied. The patients were divided based on the type of anesthesia received and were compared.
Ten (8 males) patients with PD who underwent hip fracture surgery included in the study. Six patients received SA and 4 patients received GA. The mean age was 73.2 years. The preoperative assessment was not significant for all patients. Postoperatively, within the inpatient period, 3 out of 4 patients received GA developed complications (two atelectasis and urinary tract infection) while no patient developed complication from the SA group. Postoperative outpatient complications within one-month included 3 out of 4 cases in the GA group and only one complication in the SA group. The mean hospitalization period was 9 days for patients received GA and 5.8 days for patients received SA.
This study reported less perioperative complications in the SA. Accordingly, further investigations and rp-randomized controlled trials evaluating various anesthetic techniques or drugs are needed.
麻醉医生在帕金森病（PD）患者中更倾向于使用全身麻醉（GA）。然而，全身麻醉可能会在术中掩盖神经症状，并在术后使其加重。此外，全身麻醉中使用的麻醉剂与用于控制帕金森病的药物有明确的相互作用。另一方面，脊髓麻醉（SA）中使用的药物对帕金森病患者可能更安全。本研究的目的是评估脊髓麻醉和全身麻醉对接受髋部骨折修复的帕金森病患者的影响。
我们回顾性地确定了那些因髋关节骨折入院的帕金森病患者。获取了以下信息：人口统计学资料、患者的术前评估信息、麻醉类型、骨折类型和骨科手术类型。此外，还研究了术中及术后并发症。根据所接受的麻醉类型对患者进行分组并比较。
本研究纳入了10例（8例男性）接受髋部骨折手术的帕金森病患者。6例患者接受了脊髓麻醉，4例患者接受了全身麻醉。平均年龄为73.2岁。所有患者的术前评估无显著差异。术后，在住院期间，4例接受全身麻醉的患者中有3例出现并发症（2例肺不张和尿路感染），而脊髓麻醉组无患者出现并发症。术后1个月内的门诊并发症，全身麻醉组4例中有3例，脊髓麻醉组仅有1例并发症。接受全身麻醉的患者平均住院时间为9天，接受脊髓麻醉的患者为5.8天。
本研究报告脊髓麻醉的围手术期并发症较少。因此，需要进一步的研究和随机对照试验来评估各种麻醉技术或药物。
