Despite many previous studies, whether anesthetic technique will significantly affect overall patient outcome, morbidity and mortality in elderly hip fracture patients is controversial. Due to old age, poor patient condition and emergent clinical settings, patients undergoing surgical procedures for hip fracture management are often subject to poor postoperative outcome and high mortality rates. While many studies have reported that regional anesthesia leads to improved postoperative outcome after hip fracture surgery, others have concluded otherwise. Moreover, because the majority of these previous studies are retrospective cohorts or systemic reviews, there is a need for randomized clinical trials to provide high quality evidence. This study aims to compare patient outcome between three different anesthetic techniques in elderly patients undergoing surgery for hip fracture management by evaluating proinflammatory cytokines, chemistry lab testing and clinical outcome between general anesthesia with either desflurane or propofol-based TIVA and spinal anesthesia with bupivacaine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
186
Inhalation anesthesia with desflurane at age-adjusted MAC of 0.8\~1.0
Total intravenous anesthesia with propofol target controlled infusion
Spinal anesthesia with 0.5% bupivacaine
Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University Health System
Seoul, South Korea
HMGB1
Time frame: from preoperative baseline to 72hours
IL-6
Time frame: from preoperative baseline to 72hours
NT-proBNP
Time frame: from preoperative baseline to 72hours
hemoglobin
Time frame: from preoperative baseline to 72hours
total lymphocyte count
Time frame: from preoperative baseline to 72hours
albumin
Time frame: from preoperative baseline to 72hours
creatinine
Time frame: from preoperative baseline to 72hours
potassium
Time frame: from preoperative baseline to 72hours
troponin-T
Time frame: from preoperative baseline to 72hours
CRP
Time frame: from preoperative baseline to 72hours
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