Anaesthetic aspects in the treatment of fragility fracture patients

S M White; N B Foss; R Griffiths

doi:10.1016/j.injury.2018.06.027

Anaesthetic aspects in the treatment of fragility fracture patients

Injury. 2018 Aug;49(8):1403-1408. doi: 10.1016/j.injury.2018.06.027. Epub 2018 Jun 22.

Authors

S M White¹, N B Foss², R Griffiths³

Affiliations

¹ FRCA, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom. Electronic address: [email protected].
² Department of Anaesthesiology and Intensive Care Medicine, Hvidovre University Hospital, Kettegård Allé 30, Hvidovre, Denmark.
³ North West Anglia Hospitals NHS FT, Bretton Gate, Peterborough, PE3 9GZ, United Kingdom.

PMID: 29958684
DOI: 10.1016/j.injury.2018.06.027

Abstract

As longevity increases globally, the number of older, frailer, comorbid patients requiring fragility fracture surgery will increase. Fundamentally, anaesthesia should aim to maintain these patients' pre-fracture cognitive and physiological trajectories and facilitate early (ie day 1) postoperative recovery. This review describes the 10 general principles of anaesthesia for fragility fracture surgery that best achieve these aims: multidisciplinary care, 'getting it right first time', timely surgery, standardisation, sympathetic anaesthesia, avoiding ischaemia, sympathetic analgesia, re-enablement, data collection and training.

Keywords: Hip fractures, anaesthesia; Hip fractures, epidemiology; Hip fractures, mortality; Key words.

Publication types

Review

MeSH terms

Anesthesia, Conduction*
Anesthesia, General*
Hip Fractures / physiopathology
Hip Fractures / surgery*
Humans
Orthopedic Procedures / methods*
Osteoporotic Fractures / physiopathology
Osteoporotic Fractures / surgery*
Pain, Postoperative
Postoperative Complications
Practice Guidelines as Topic
Quality of Health Care
Recovery of Function / physiology*