EFFECT OF GENERAL AND SPINAL ANESTHESIA ON POSTOPERATIVE MYOCARDIAL INJURY IN ELDERLY PATIENTS UNDERGOING HIP FRACTURE SURGERY: A RANDOMIZED STUDY
TL;DR
General and spinal anesthesia were related to similar postoperative myocardial injury rates in elderly patients undergoing hip surgery, and showed no significant difference in MINS incidence, troponin changes, mortality, hospital stay, or ICU stay.
Abstract
Introduction: Postoperative myocardial injury following non-cardiac surgery is a clinically relevant complication in elderly patients and is related to worse postoperative outcomes. This study investigated whether anesthesia technique affects the development of myocardial injury after hip surgery in elderly patients. Materials and Method: This prospective randomized single-blind study included 100 patients older than 65 years with hip fractures who were scheduled for hip fracture surgery classified as American Society of Anesthesiologists physical status II–III who were scheduled for hip surgery. Patients received either general or spinal anesthesia according to group allocation. Age, sex, baseline hemodynamic parameters, intraoperative heart rate, and mean arterial pressure values were monitored at 10-minute intervals. Troponin T levels were assessed before surgery and repeatedly during the first 72 postoperative hours. Intensive care unit stay, hospital stay, postoperative complications, and 30-day mortality were also evaluated. Results: The general and spinal anesthesia groups showed no significant difference in MINS incidence, troponin changes, mortality, hospital stay, or ICU stay. Conclusion: General and spinal anesthesia were related to similar postoperative myocardial injury rates in elderly patients undergoing hip surgery. Keywords: Troponin; Anesthesia, Spinal; Anesthesia, General; Orthopedic Procedures.