Continuous spinal anaesthesia in frail patients for hip fracture surgery

Abstract

Aim
We sought to examine the morbidity and mortality of elderly, frail patients receiving continuous spinal anaesthesia for hip fracture repair in a tertiary hospital.

Methods
We reviewed the medical records of 58 patients who underwent CSA for hip fracture repair during a six-month period (January – July 2019). We examined patient’s records for; (i) performance of an echocardiogram (ii) adverse peri-operative outcomes (iii) length of stay and (iv) discharge disposition.

Results
8 patients (14%) died in hospital. 24 patients (41%) had a length of hospital stay almost double that of the national average (19 vs 11 days, respectively). Only 24 (41%) of patients had an echocardiogram performed in the last five years with just two displaying features of severe aortic stenosis.

Discussion
Where there is concern surrounding physiological robustness in an elderly patient with a hip fracture a technique of CSA can be used to avoid the need for general anaesthesia and expedite access to definitive surgery.