- This is a single-center, prospective, randomized study evaluating hemodynamic outcomes between two anesthesia techniques, hypobaric unilateral spinal anesthesia (HUSA) and general anesthesia (GA), among elderly patients undergoing hip fracture surgery.
- The HUSA group received an intrathecal injection of a hypobaric anesthetic solution (containing 9 mg ropivacaine, 5 μg sufentanil, and 1 ml sterile water) at the lumbar subarachnoid space and the GA group received etomidate, desflurane and a remifentanil infusion.
- The study’s primary outcome was hypotension (defined as MAP <65 mm Hg for >12 consecutive minutes) and secondary outcomes included myocardial injury after non-cardiac surgery, acute kidney injury, and 30-day mortality.
- Of the 146 included patients (82 in HUSA and 64 in GA group), the authors reported increased hypotension and vasopressor requirements in the GA group as compared to the HUSA group. There was no difference in myocardial injury after non-cardiac surgery, acute kidney injury and 30-day mortality between the two groups.
- In conclusion, the HUSA technique is beneficial for elderly patients in terms of lesser episodes of hypotension and reduced vasopressors need than general anesthesia.
Summary of "Hypobaric Unilateral Spinal Anesthesia Versus General Anesthesia for Hip Fracture Surgery in the Elderly: A Randomized Controlled Trial"
Summary published February 3, 2023