Naslov
Spinal anaesthesia in elderly patients with specific cardiovascular conditions

Autori
Šakić, Kata ; Grljušić, Marijana

Izvornik
Periodicum Biologorum (0031-5362) 109 (2007); 255-259

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, pregledni rad, znanstveni

Ključne riječi
spinal anaesthesia; cardiovascular diseases

Sažetak
Many surgical procedures are primarily performed one elderly patients.Patients presenting for hip fracture surgery, orthopedics, urology, ginecology and oncology have a a high prevalence of preoperative cardiac problems and may require medical stabilization before surgery.Spinal anaesthesia may be contraindicated due to perioperative pharmacological prophylaxis for deep venous thrombosis. The use of spinal anaesthesia increases the magnitude and frequency of hypotensive episodes when compared with general anaesthesia. Intraoperative blood loses are sometimes affected by anaesthetic technique.Following hip fracture surgery under spinal anaesthesia , patients exhibit better oxygenation in the early postoperative period than those after general anaesthesia. The frequency of postopertive confusion is unrelated to anaesthetic technique. The incidence of deep venous thrombosis is reduced following spinal anaesthesia as compared with general anaesthesia. The one-month mortality rate , approximately eight percent , is unrelated to anaesthetic technique. Spinal, epidural and general anaesthesia have been used successfully for total hip arthroplasty. Intraoperative blood loss is reduced with regional anaesthesia. Intraoperative instability with hypoxemia, hypotension and cardiac arrest may follow impaction of the prosthesis and are related to absorption of acrylic cement monomers and pulmonary embolism of fat, air and platelet-fibrin aggregates. Postoperative deep venous thrombosis is common and the incidence may be reduced with spinal anaesthesia. Operative mortality is less than one percent and pulmonary embolism is the commonest cause of death.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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