Spinal Versus General Anesthesia on Postoperative Pulmonary Complications

Tongji Hospital40 enrolled

Overview

The objective of this study was to investigate the difference in postoperative pulmonary complications (PPCs) between spinal anesthesia and general anesthesia in patients undergoing delayed hip surgery.

In this study, the difference of 30 min arterial partial pressure of oxygen after operation was used as the main outcome index. By means of pulmonary ultrasound, pulmonary function monitoring and other physical and biochemical examinations, the difference of postoperative pulmonary complications between spinal anesthesia and general anesthesia in patients with delayed operation of hip fracture longer than 48 hours was compared.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Enrollment

Conditions

Pulmonary Complication Anesthesia Hip Fractures

Interventions

spinal anesthesiaPROCEDURE

An intrathecal anesthetic technique.

general anesthesiaPROCEDURE

An intravenous (combined with inhalation) anesthetic technique.

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients ≥ 65 years old * ASA Class I \~ III * Surgical repair of femoral neck, intertrochanteric or subtrochanteric fractures * The time from diagnosis to surgery is more than 48 hours Exclusion Criteria: * Unable to walk about 3 meters or across a room without assistance before the fracture * Emergency surgery * Congestive heart failure, asthma, anemia (Hb \< 90 g/L), hypoalbuminemia (ALB \< 35g/L) * Abnormal coagulation function * Severe aortic stenosis * Injection site infection or increased intracranial pressure * Patients have participated in previous trials or have been determined by a surgeon or anesthesiologist to be unsuitable for randomization * The written informed consent of the patient or his/her representative cannot be obtained

Locations (1)

Tianzhu Liu

Wuhan, Hubei, China

RECRUITING

Outcomes

Primary Outcomes

Arterial partial pressure of oxygen, PaO2

PaO2 was measured by arterial blood gas analysis

Time frame: 30 minutes after surgery

Secondary Outcomes

Arterial partial pressure of oxygen, PaO2

PaO2 was measured by arterial blood gas analysis

Time frame: 30 minutes before surgery

Forced vital capacity, FVC

FVC was measured by Spirometer (SP70B)

Time frame: 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery

Forced expiratory volume in 1 second, FEV1

FEV1 was measured by Spirometer (SP70B)

Time frame: 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery

Peak expiratory flow, PEF

PEF was measured by Spirometer (SP70B)

Time frame: 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery

PEF 25, 75, and 25-75

PEF 25, 75, and 25-75 were measured by Spirometer (SP70B)

Time frame: 30 minutes before surgery; 30 minutes after surgery; 24 hours after surgery

Lung Ultrasound Score (LUS)

Bedside measurements using portable ultrasound

Time frame: 30 minutes before surgery, 30 minutes after surgery, 24 hours after surgery

Postoperative pulmonary complications

Pulmonary complications (PPCs) include: (1) Evidence of pneumonia, pneumothorax, atelectasis and pleural effusion indicated by postoperative pulmonary ultrasound, chest film or chest CT; ② After surgery, the patient developed bronchospasm, ARDS, O2 requirement (nasal catheter or mask), non-invasive ventilation requirement, or unplanned endotracheal intubation/mechanical ventilation for more than 1 day; ③ The increase of inflammatory biochemical indexes 24 h after surgery suggested systemic inflammatory response (blood routine, C-reactive protein CRP, procalcitonin PCT and IL-6, IL-1β, TNF-α).

Central Contacts

Tianzhu Liu, M.D.

CONTACT

13098866448 liutzh@126.com

Data from ClinicalTrials.gov

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