[Epidural anesthesia for the repair of the femoral neck fracture in elderly patients].

For the repair of the femoral neck fracture in the elderly patients, an epidural catheter was inserted immediately after injury and epidural anesthesia was employed to allow radical operation as early as possible. The subjects were 45 patients with a mean age of 81.4 years. Surgical procedures were osteosynthesis and replacement of the femoral cap. The preoperative management of pain included insertion of an epidural catheter at the L2-L4 interspace immediately after injury for injection of 0.25% bupivacaine. The catheter was inserted 1.5 days on average after injury, and surgery was undertaken 1.4 days on average after the insertion. The intraoperative management included epidural anesthesia by injection of 1.5% mepivacaine. The mean duration of anesthesia was 150 min, and the total amount of mepivacaine used during the operation averaged 284 mg. For postoperative management, the epidural catheter was retained for 5 days on average to achieve adequate pain relief. The incidence of postoperative complications was relatively low, and the post operative course was also favorable.