Abstract

OUTCOME AFTER ANESTHESIA AND SURGERY FOR FRACTURE OF THE HIP IN PATIENT AGED OVER 100 YEARS. THE “OLDEST OLD” OF THE NEW MILLENNIUM.

Luiz Eduardo Imbelloni – MD*, PhD, Siddharta Lacerda – MD, Robson Barbosa – MD, Marildo A. Gouveia – MD and Geraldo B. Morais Filho MSc

ABSTRACT

Background: In 2010 there were 757 elderly over 100 years in the state of Paraíba, Brazil. Hip fracture in the elderly patients with osteoporosis is a frequent injury result from relatively low energy trauma. The purpose of this study was to investigate the outcome of 26 centenarians’ patients with hip fractures according to postoperative acceleration project. Methods: Between January 2012 and December 2016 inclusive, 26 patients (4 men and 22 women) aged 100 years and older with hip fracture were prospectively analyzed. Information on the pre-operative condition of these patients, mode of anesthesia, drugs used, intra-operatively measured variables and immediate post-operative variables measured in the post-anesthesia care unit, and first day of postoperative was obtained from the study protocol. Results: Prior to injury, all patients had normal life at home. The average hospital stay until the day of surgery was 4.76±2.61 days. The mean fasting time was 2:40±0:35 hours. All patients were submitted to spinal anesthesia. The dose ranged from 6 to 10 mg of isobaric bupivacaine. The duration of the spinal block was 2:38±0:44 hours, the time for the use of dextrinomaltose was 1:47±0:54 hours, the time in the PACU was 2:03±0:47 hours and the time to reintroduce normal meals were 6:09±1:04 hours. Arterial hypotension occurred in 1 patients and delirium in 2 patients. Two deaths occurred within the first 30 postoperative days. Conclusion: There is a predominance of women over 100 years. Our prospective analysis shows that the centenarians tolerated anesthesia and surgery, and can fully participate in projects accelerated postoperative recovery, with only two deaths in the first 30 postoperative days.

Keywords: Surgery, orthopedic, Spinal anesthesia, Fasting, Perioperative Care, Fast-track surgery.