Ishida Yoshiaki, Ogura Fumiko, Kondo Satoko, Toba Yoshie
Anesthesiology, Seirei Hamamatsu Hospital, Hamamatsu, Shizuoka, Japan
Anesthesiology, Seirei Hamamatsu Hospital, Hamamatsu, Shizuoka, Japan.
BMJ Case Rep. 2021 Apr 26;14(4):e239468. doi: 10.1136/bcr-2020-239468.
Hip fracture is a common injury in elderly patients. In Japan, the number of super-old patients-age >90 years-with hip fractures has increased drastically over time. Available strategies for anaesthetic management for hip fracture surgery include general anaesthesia, neuraxial anaesthesia and peripheral nerve block. However, general and neuraxial anaesthesia are often avoided for various reasons, particularly in elderly patients. In recent years, peripheral nerve block has proven effective in various surgical procedures. Additionally, dexmedetomidine exhibits neuroprotective effects and has been used safely in super-old patients. Herein, we demonstrate successful anaesthetic management with peripheral nerve block under dexmedetomidine sedation for open reduction and internal fixation of a femoral neck fracture in a 97-year-old patient.
髋部骨折是老年患者的常见损伤。在日本，年龄超过90岁的超高龄髋部骨折患者数量随着时间的推移急剧增加。髋部骨折手术麻醉管理的可用策略包括全身麻醉、神经轴索麻醉和外周神经阻滞。然而，由于各种原因，全身麻醉和神经轴索麻醉常常被避免使用，尤其是在老年患者中。近年来，外周神经阻滞已被证明在各种外科手术中有效。此外，右美托咪定具有神经保护作用，并已在超高龄患者中安全使用。在此，我们展示了在右美托咪定镇静下，对一名97岁股骨颈骨折患者进行切开复位内固定手术时，采用外周神经阻滞成功进行麻醉管理的病例。
