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Review
. 2024 Feb;22(1):96-104.
doi: 10.1007/s11914-023-00835-1. Epub 2023 Dec 22.

Anesthetic Methods for Hip Fracture

Lisa Reider  1 , David Furgiuele  2 , Philip Wan  2 , Benjamin Schaffler  3 , Sanjit Konda  4   5 ; METRC (Major Extremity Trauma Research Consortium)
Affiliations
Review

Anesthetic Methods for Hip Fracture

Lisa Reider et al. Curr Osteoporos Rep. 2024 Feb.

Abstract

Purpose of review: To review the benefits, risks, and contraindications of traditional and new anesthesia approaches for hip fracture surgery and describe what is known about the impact of these approaches on postoperative outcomes.

Recent findings: This review describes general and spinal anesthesia, peripheral nerve block techniques used for pain management, and novel, local anesthesia approaches which may provide significant benefit compared with traditional approaches by minimizing high-risk induction time and decreasing respiratory suppression and short- and long-term cognitive effects. Hip fracture surgery places a large physiologic stress on an already frail patient, and anesthesia choice plays an important role in managing risk of perioperative morbidity. New local anesthesia techniques may decrease morbidity and mortality, particularly in higher-risk patients.

Keywords: Hip fracture; Local anesthesia; Monitored anesthesia care.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Prevention CfDCa: https://www.cdc.gov/falls/hip-fractures.html (2020). Accessed June 26, 2023 2023.
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    1. •• Konda SR, Ranson RA, Dedhia N, Tong Y, Saint-Cyrus E, Ganta A, et al. Monitored anesthesia care and soft-tissue infiltration with local anesthesia: an anesthetic option for high-risk patients with hip fractures. J Orthop Trauma. 2021;35(10):542–9. This single-center pilot study showed that MAC-STILA was associated with decreased lability of intraoperative physiologic parameters (heart rate and blood pressure) and lower rates of postoperative pain and delirium compared with general and spinal anesthesia. MAC-STILA is feasible and safe and may be better than traditional anesthesia approaches for high-risk patients or patients with contraindications to spinal or general anesthesia. - DOI

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