[Which anesthetic technique is more suitable for hip fracture surgery in patients above the age of 85, spinal or epidural?].
BACKGROUND
Anesthesia for hip fracture in elderly patients is a challenge because of their reduced functional reserve. We compared spinal and epidural anesthesia retrospectively in the operations of hip fracture in patients above the age of 85.


METHODS
Two hundred and eighteen operations from April 1995 to September 2003 in our hospital were examined. Epidural anesthesia was scheduled in 94 operations, and bupivacaine spinal anesthesia in 86 operations. Successful anesthetic cases of each group were compared. Blood pressure, heart rate, doses of vasopressors used were recorded before anesthesia and first and second 30-minute periods after anesthesia.


RESULTS
Failed anesthetic cases in epidural anesthesia were significantly more than those in spinal anesthesia. Blood pressure in the first 30-minute period after epidural anesthesia was significantly lower than that after spinal anesthesia.


CONCLUSIONS
Spinal anesthesia is preferable for the operation for hip fracture compared with epidural anesthesia, because of fewer failed cases and smaller decreases of blood pressure.
Asao
Yasuhiro
Y
Department of Anesthesia, Tottori Municipal Hospital, Tottori.
Kasai
Shin-Ya
SY
Higuchi
Tomoyasu
T
Tsubaki
Noriko
N
Kobayashi
Osamu
O
D000368:Aged; D000369:Aged, 80 and over; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D001794:Blood Pressure; D005260:Female; D005853:Geriatrics; D006339:Heart Rate; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies