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老年患者髋部骨折手术的麻醉管理:综述

Anesthesia Management of Hip Fracture Surgery in Geriatric Patients: A Review.

作者信息

Uppalapati Tarun, Thornton Imani

机构信息

Anesthesiology, HCA Florida Westside Hospital, Plantation, USA.

Anesthesiology and Critical Care, HCA Florida Westside Hospital, Plantation, USA.

出版信息

Cureus. 2024 Sep 25;16(9):e70188. doi: 10.7759/cureus.70188. eCollection 2024 Sep.

Abstract

Hip fractures are increasingly prominent concerns in healthcare, especially in light of a growing elderly population. These fractures contribute to mortality and morbidity in the elderly. Many hip fractures require emergent surgical intervention and may have consequences of serious postoperative complications. Multidisciplinary approaches of management have been utilized to optimize care and improve patient outcomes. Due to the myriad of multi-organ system comorbidities that are increasingly prevalent in the geriatric population, anesthetic management proves to be difficult to standardize. Enhanced Recovery After Surgery (ERAS) protocols have shown benefits for optimizing patient outcomes by focusing on premedication, nutritional support, and pain management; however, specific anesthetic management techniques are not discussed. This literature review aims to discuss ways to optimize hip fracture management in geriatric patients through effective preoperative evaluation, anesthetic considerations, and postoperative optimization and care. A review of currently available guidelines may help determine the optimal management for hip fractures in geriatric patients and improve immediate and lasting postoperative outcomes.

摘要

髋部骨折在医疗保健领域日益受到关注,尤其是考虑到老年人口不断增加的情况。这些骨折会导致老年人的死亡率和发病率上升。许多髋部骨折需要紧急手术干预,并且可能会出现严重的术后并发症。多学科管理方法已被用于优化护理并改善患者预后。由于老年人群中越来越普遍的多种多器官系统合并症,麻醉管理难以标准化。术后加速康复(ERAS)方案已显示出通过关注术前用药、营养支持和疼痛管理来优化患者预后的益处;然而,未讨论具体的麻醉管理技术。这篇文献综述旨在讨论通过有效的术前评估、麻醉考虑以及术后优化和护理来优化老年患者髋部骨折管理的方法。对现有指南的回顾可能有助于确定老年患者髋部骨折的最佳管理方法,并改善术后的即时和长期预后。

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[Research status of the enhanced recovery after surgery in the geriatric hip fractures].老年髋部骨折术后加速康复的研究现状
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Review of Postoperative Delirium in Geriatric Patients After Hip Fracture Treatment.老年髋部骨折治疗后术后谵妄的综述
Geriatr Orthop Surg Rehabil. 2022 Mar 4;13:21514593211058947. doi: 10.1177/21514593211058947. eCollection 2022.

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