| Abstract [eng] |
Objective: Search on, gather and analyze literature and clinical cases based on the latest recommendations for anesthesia selection in elderly patients after hip trauma, present summaries and propose the most appropriate anesthesia strategy for such patients. Methods: This literature review was conducted in the „PubMed“, „Cochrane Library“ and „ScienceDirect“ databases. The search was carried out by using the following keywords: „elderly patient“, „geriatric patient“, „anaesthesia“, „hip fracture“, „arthroplasty“, „surgery“. Results: Perioperative and postoperative complications related to both regional and general anaesthesia can be expected during hip surgery. The 30-day post-operative mortality rate does not differ significantly between these anaesthetic modalities, so attention should be paid to a detailed examination of the elderly patient and an individualised treatment strategy. In the perioperative and postoperative periods, general anaesthesia has a higher incidence of complications related to postoperative pain, bleeding, pneumonia and delirium, whereas regional anaesthesia has a higher incidence of complications related to haemodynamics (episodes of hypotension) and deep vein thrombosis. The incidence of complications such as nausea and vomiting, myocardial infarction, pulmonary artery thromboembolism does not differ significantly between anaesthetic tactics. Different peripheral nerve blockades (fascia iliaca nerve fibre block, lumbar plexus block, pericapsular nerve block), opioid preparations or infiltration of surgical wounds with anaesthetics are recommended for effective post-operative pain relief. The duration of hospitalisation does not differ significantly between regional and general anaesthesia, but may be influenced by factors such as post-operative complications or nosocomial infections. Conclusions: Based on the literature, treatment guidelines and clinical trials, anaesthesia, surgical management and even post-operative care and recovery tactics, tailored to the individual patient's physical characteristics, are recommended to minimise the risk of peri- and post-operative complications, reduce the incidence of mortality and the overall length of hospital stay, and improve the chances of recovery. Keywords:elderly patient, geriatric patient, anaesthesia, hip fracture, arthroplasty, surgery. |
