title: Early percutaneous pinning of hip fracture using propofol-ketamine-lidocaine admixture in a geriatric patient receiving dabigatran: a case report.
abstract: Hip fractures occur commonly in elderly patients. Many of these patients have multiple comorbidities requiring the use of anticoagulants. Some of the newer anticoagulants have no reliable method for reversal. This case report discusses the advantages and pitfalls of the selection of local anesthetic and monitored anesthesia care using a propofol-ketamine-lidocaine admixture for an elderly patient with a femoral neck fracture who was receiving dabigatran etexilate (Pradaxa). This case illustrates the potential for sedation during monitored anesthesia care to progress to general anesthesia and its associated risks as well as special considerations for anesthesia in geriatric patients.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hickel
mesh_terms: D000369:Aged, 80 and over; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D000991:Antithrombins / Q000008:administration & dosage; D001562:Benzimidazoles / Q000008:administration & dosage*; D001858:Bone Nails; D000069604:Dabigatran; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008012:Lidocaine / Q000008:administration & dosage*; D009719:Nurse Anesthetists; D015742:Propofol / Q000008:administration & dosage*; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D007649:Ketamine; D008012:Lidocaine; D000069604:Dabigatran; D015742:Propofol