Department of Anesthesiology, Intensive Care and Pain Medicine.
Department of Orthopedic, Trauma- and Handsurgery, Florence-Nightingale-Hospital, Düsseldorf, Germany.
Curr Opin Anaesthesiol. 2021 Feb 1;34(1):33-39. doi: 10.1097/ACO.0000000000000941.
Hip fractures of the elderly population are a common trauma and numbers are increasing due to ageing societies. Although this is an ordinary low energy impact injury and surgical repair techniques show good results, the perioperative course is characterized by an unparalleled disproportionate perioperative morbidity and mortality.
Most studies focus on outcome-related data. Little is known on how to prevent and treat adverse sequelae, ranging from mild physical challenges to neurobiological disorders and death.
Although the contribution of the anaesthetic technique per se seems to be small, the role of the anaesthesiologist as a perioperative physician is undisputed. From focusing on comorbidities and initiating preoperative optimization to intraoperative and postoperative care, there is a huge area to be covered by our faculty to ensure a reasonable outcome defined as quality of postoperative life rather than merely in terms of a successful surgical repair. Protocol-driven perioperative approaches should be employed focusing on pre, intraoperative and postoperative optimization of the patient to facilitate early repair of the fracture that may then translate into better outcomes and hence alleviate the individual patient's burden as well as the socioeconomic load for society.
老年人髋部骨折是一种常见的创伤，由于老龄化社会的到来，其发病率正在上升。尽管这是一种普通的低能量创伤，且手术修复技术效果良好，但围手术期的特点是围手术期发病率和死亡率不成比例。
大多数研究都集中在与结果相关的数据上。对于如何预防和治疗从轻微的身体挑战到神经生物学障碍和死亡等不良后果知之甚少。
尽管麻醉技术本身的作用似乎很小，但麻醉师作为围手术期医生的角色是毋庸置疑的。从关注合并症和开始术前优化，到术中及术后护理，我们的专业人员需要涵盖一个巨大的领域，以确保一个合理的结果，定义为术后生活质量，而不仅仅是成功的手术修复。应该采用基于方案的围手术期方法，重点是优化患者的术前、术中和术后状况，以促进骨折的早期修复，从而改善治疗结果，减轻患者个体的负担以及社会的社会经济负担。
