[Propofol to facilitate spinal anesthesia in the lateral position in patients with femoral neck fracture].
OBJECTIVE
The aim of this study was to assess the feasibility and efficacy of propofol before positioning elderly patients with a femoral neck fracture in the lateral decubitus position, to perform a spinal anesthetic.


METHODS
In this prospective and descriptive study, 79 consecutive patients, > 75 yr old, with a femoral neck fracture were included. Propofol, 0.5 mg x kg(-1), was administered. If loss of consciousness was not obtained (Ramsay score < or = 3/6), then additional doses of 0.25 mg x kg(-1) were given until a Ramsay score of 4 or 5 was attained. Then, the patient was turned to the lateral decubitus position, the fractured side up. The efficacy of propofol was assessed by observing a grimace during positioning and asking the patients if they had recall of pain. Hemodynamic data and oxygen saturation were collected.


RESULTS
Forty-three patients required a single injection, 34 required two injections and only two patients required three injections. No grimace and no recall of pain were recorded during the study. There was no desaturation (SpO(2) < 92 %), and hypotension, defined as a systolic blood pressure decrease > 30% from baseline, was observed.


CONCLUSIONS
Propofol is a simple and efficacious means of providing comfort while positioning elderly patients with a femoral head fracture before performing spinal anesthesia.
Minville
Vincent
V
Département d'anesthésie et de réanimation, CHU Toulouse - Rangueil, Université Paul Sabatier, 1, 31400 Toulouse, France. vincentminville@yahoo.fr
Castel
Adeline
A
Asehnoune
Karim
K
Chassery
Clément
C
Lafosse
Jean-Michel
JM
Nguyen
Luc
L
Colombani
Aline
A
Fourcade
Olivier
O
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000379:methods; D001794:Blood Pressure; D016292:Procedural Sedation; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008297:Male; D011187:Posture; D015742:Propofol / Q000008:administration & dosage*; D014463:Ultrasonography
D006993:Hypnotics and Sedatives; D015742:Propofol