A national survey into the peri-operative anaesthetic management of patients presenting for surgical correction of a fractured neck of femur.
We conducted a national postal survey of trauma anaesthetists in the UK to ascertain current practice for the peri-operative anaesthetic management in patients with fractured necks of femur. We received 155 replies from 218 questionnaires sent (71.1% response rate). Regional anaesthesia was preferred by 75.8% of respondents, with 95.5% of these employing a spinal technique. This was generally performed bad side down (45.7%) using ketamine (37.3%) and/or midazolam (41.2%) to aid positioning. In all, 31.4% used fentanyl in the intrathecal injectate, whereas only 5.9% used morphine. Paracetamol and morphine were the most commonly used postoperative analgesic regimens with non-steroidal anti-inflammatory drugs used by only 27.4%. Continuous epidural or nerve block infusions were used rarely. Of the anaesthetists, 50.6% would only request a pre-operative echo if there were suspicious signs or symptoms in patients with a previously undiagnosed heart murmur. The peri-operative management of these patients can be readily improved.
Sandby-Thomas
M
M
Department of Anaesthetics and Intensive Care, University Hospital of Wales/University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN. msandbythomas@btinternet.com <msandbythomas@btinternet.com>
Sullivan
G
G
Hall
J E
JE
D000698:Analgesia / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000379:methods / Q000706:statistics & numerical data; D016292:Procedural Sedation / Q000379:methods; D004452:Echocardiography / Q000706:statistics & numerical data; D005265:Femoral Neck Fractures / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods*; D019538:Health Care Surveys; D006337:Heart Murmurs / Q000000981:diagnostic imaging; D006801:Humans; D010149:Postoperative Pain / Q000628:therapy; D019990:Perioperative Care / Q000379:methods; D011187:Posture; D011364:Professional Practice / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom