Special anesthetic consideration for the patient with a fragility fracture.
In this article, an overview is presented of perioperative management of the patient with a fragility fracture, including preoperative risk stratification and optimization, anesthesia risks, anesthesia options, and postoperative pain management. Issues of preoperative evaluation that are of concern for the anesthesiologist because of their direct effect on intraoperative care are discussed. A team interdisciplinary approach and good communication between specialties involved in care of elderly surgical patients is important for optimal patient outcomes and to avoid perioperative complications. Cooperation between anesthesiology and medicine is indispensable in reaching a reasonable consensus regarding preoperative evaluation and should occur on a case-by-case basis.
Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Sheik Zayed Tower 8-120, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address: ouanes@jhu.edu.
Jean-Pierre P
JP
Ouanes
Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Sheik Zayed Tower 8-120, 1800 Orleans Street, Baltimore, MD 21287, USA.
Vicente Garcia
VG
Tomas
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, The Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Room A5W-588, Baltimore, MD 21224, USA.
Frederick
F
Sieber
D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods*; D015897:Comorbidity; D050723:Fractures, Bone / Q000601:surgery*; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration*; D011300:Preoperative Care / Q000379:methods*; D018570:Risk Assessment / Q000379:methods
Elderly; Epidural anesthesia; Fragility fractures; General anesthesia; Orthopedic fractures; Regional anesthesia