Epidural Anesthesia In High Risk Geriatric Patients Posted For Surgries Of Femur Fracture

Abstract

Background:With advancement in health-care, more numbers of elderly patients are being operated for lower-limb orthopaedic surgeries. As these patients have many physiological differences compared to general population along with severe co-morbidities, general anaesthesia becomes very challenging in preoperative period. Epidural anaesthesia, on other hand, offers very good intra operative anaesthesia along with prolonged postoperative analgesia. Side-effects of general anaesthesia are avoided. Objective of our study is to observe potential and proven benefits of epidural anaesthesia and analgesia in high-risk geriatric patients undergoing surgeries for femur fracture. Material And Methods:After approval from institutional review board, this study was conducted in 30 high-risk elderly patients undergoing elective surgery for femur fracture. They were given epidural anaesthesia with placement of an epidural catheter. 7-10 ml of 1.5% Lignocaine with Adrenaline was given as initial dose. Supplemental dose of 5 ml of 0.5% Bupivacaine as required if surgery lasted for more than 1.5 hours. Patients were monitored in terms of pulse, blood pressure, respiratory rate, SpO2. Analgesia in postoperative period was assessed by VAS score. Result:Epidural anaesthesia offers several advantages over general anaesthesia like stable preoperative hemodynamics, postoperative analgesia, reduced thromboembolic events. Conclusion:Epidural anaesthesia appears to be safe and beneficial in elderly patients having various comorbidities, however consideration should be given to the health status of the patient and the surgical requirements.[Bhavsar G Natl J Integr Res Med, 2020; 11(5):01-05]