ANESTHETIC MANAGEMENT IN HIP FRACTURE: A REVIEW

Dr. Varsha Dubal*

ABSTRACT

Hip fracture is commonest injury occurring in elderly people, due to trivial fall. It is more common in female than males, and its incidences rises with increase in age. Hip fracture is associated with a 12-month mortality of 20-25%a four-fold higher mortality than age-matched community-living controls. Half of these patients suffer decreased mobility and independence following fracture and only a third regain pre-fracture levels of function Patients presenting with hip fracture commonly suffer chronic medical diseases, and are at high risk of perioperative cardiac morbidity and mortality. Early institution of epidural analgesia in patients with known cardiac disease reduces cardiac morbidity. The provision of epidural analgesia aids mobilization by providing superior dynamic analgesia and reduces postoperative cardiac morbidity. Continuous peripheral nerve blockade is a promising alternative to epidural analgesia but requires further study. With the incidence of hip fracture expected to increase significantly in parallel with an aging population, the anesthetist will continue to be an important part of the multidisciplinary team approach to the management of the patient with hip fracture.

Keywords: Analgesia, Cardiac disease, Elderly, Hip fracture.